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S.M. Michels, P.J. Rosenfeld, W. Geitzenauer, F. Prager, A. Rosin, G. Kornek, L. Vormittag, U. Schmidt–Erfurth; Standard vs. Reduced Dose Systemic Bevacizumab (Avastin®) for the Treatment of Neovascular Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5231.
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To compare the initial treatment responses following 2.5 or 5 mg/kg intravenous bevacizumab in patients with neovascular age–related macular degeneration (AMD).
In a prospective cohort study, 14 eyes (8 patients) were treated with 5 mg/kg and 12 eyes (7 patients) with 2.5 mg/kg intravenous bevacizumab. All patients received 3 i.v. infusions at 2 week intervals and completed 3 months follow–up. Patients were monitored at least every 4 weeks by ETDRS visual acuity, optical coherence tomography (OCT), and fluorescein angiography (FA).
Both groups showed a response to treatment after the first infusion. At day 7, mean visual acuity (VA) increased from 56.3 letters at baseline to 60.4 letters in the 5 mg/kg group and the mean central retinal thickness, as measured by OCT, decreased by 83 µm. In the 2.5 mg/kg group, the mean VA increased from 59.8 letters to 65.5 letters and the mean OCT central retinal thickness (CRT) decreased by 106 µm. At 3 months follow–up, VA improved by 8 letters compared to baseline in the 5 mg/kg group and by 11 letters in the 2.5 mg/kg group. CRT was reduced by 121µm in the 5 mg/kg group and 138µm in the 2.5 mg/kg group. In all patients, leakage documented by FA was absent or significantly reduced by 3 months follow–up.
Initial treatment responses to 2.5 and 5mg/kg bevacizumab in patients with neovascular AMD appear comparable. Further follow–up is required to evaluate durability and long–term safety of both treatment regimens.
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