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N. Eter, V. Hamelmann, S. Karl, H.M. Helb, M. Ladewig, F.G. Holz; Intravitreal Injection of Bevacizumab (Avastin) in the Treatment of Choroidal Neovascularization and Macular Edema . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5244.
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Bevacizumab, an anti–VEGF agent, has been introduced for systemic treatment of colorectal cancer. Since VEGF plays an important role in the pathogenesis of choroidal neovascularization (CNV) and vascular hyperpermeability, we investigated the effect of intravitreal injections of Bevacizumab in eyes with neovascular AMD and macular edema of other cause.
Forty–eight eyes of 48 patients were treated with a 1.25mg (0.06 ml) intravitreal Bevacizumab injection, 18 in combination with photodynamic therapy (PDT). Baseline and follow–up examinations one week and one month after treatment included ETDRS best–corrected visual acuity, digital fluorescein angiography, and optical coherence tomography (OCT3, Zeiss Humphrey).
Treatment was applied to 34 eyes with AMD and active, subfoveal CNV, 7 eyes with CNV due to other causes, 3 eyes with diabetic macular edema, and 4 eyes with macular edema secondary to central retinal vein occlusion. At baseline, mean visual acuity was 48±17 letters, and a mean foveal thickness of 407±149 µm was noted. One week after treatment foveal thickness decreased to 302±141µm (P=0.001), which was maintained 4 weeks after injection (P=0.021). Visual acuity showed only slight improvement: 51±15 letters (P=0.002).
A single intravitreal injection of 1.25 mg Bevacizumab may induce a marked reduction in macular edema. Despite this morphological effect, short–term visual acuity gain may be comparably small in extent. There was no evidence of intraocular inflammatory signs following the intravitreal injection. Expanded clinical studies appear warranted to assess safety and long–term effects as well as the necessity for repeated injections.
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