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K.W. Small, R. Silva–Garcia; Bevacizumab, Intravitreal Treament for Exudative Macular Degeneration (AMD) . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5229.
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Preliminary reports of intravitreal BEVACIZUMAB (an anti–VEGF monoclonal antibody) suggested beneficial effects in a few cases of wet age–related macular degeneration (AMD). We wanted to review our clinical experience in a private practice setting with this new treatment because our clinical impression was favorable.
Retrospective consecutive case review of 59 cases. Pre and post injection data that was reviewed consisted of best corrected visual acuity, macular thickness by OCT, fundus photography and fluorescein angiography (IVFA). Of the 59 cases, we have at least 2 month follow–up data on 50 cases.
No complications or adverse events were observed. The visual acuity improved by 0.77 lines on average (ranged from –2 to +8 lines). 49 of 50 were stable or improved (within 2 lines of baseline vision). 6 of 50 had improved by more than 3 lines of visual acuity. The OCT demonstrated on average 73 microns improvement in thickness (range 913–26 microns less thickening). 43 of the 50 subjects showed clinical and / or IVFA signs of improvement (i.e. less submacular fluid , blood or exudate).
Intravitreal BEVACIZUMAB seems safe and well tolerated for at least 3 months following injection. Overall, subjects seemed to show a good response to intravitreal BEVACIZUMAB. Duration of exudative AMD and previous treatments correlated with poor visual outcomes. The cases that had the best outcomes were ones with relatively new (less than 3 months duration) choroidal neovascularization and which had not been previously treated with photodynamic therapy and / or Macugen. Although the follow–up is relatively brief, the rapid postive and sometimes dramatic responses seem superior to other current standard of care treaments. Six month follow – up data of these subjects will be analyzed and presented.
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