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F. Prager, S. Michels, W. Geitzenauer, U. Schmidt–Erfurth; Comparison of Early Response to Systemic or Intravitreal Bevacizumab (Avastin®) in Patients With Neovascular AMD . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5245.
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To compare initial treatment response in patients with neovascular age–related macular degeneration (AMD) treated either with systemic or intravitreal bevacizumab.
15 patients (23 eyes) with neovascular AMD were treated with two intravenous infusions of either 2.5 or 5 mg/kg and 23 patients (23 eyes) were treated with one intravitreal injection of bevacizumab. All eyes showed active choroidal neovascularization at baseline. Evaluation included visual acuity (ETDRS) and optical coherence tomography (OCT) at baseline, day one, week one and week four.
Baseline visual acuity was 20/80 in the systemically treated group and 20/100 in the intravitreally treated group. Central retinal thickness (CRT) decreased already by day one in both groups, with a mean reduction of 51.3 µm in the systemically treated group and 49.3 µm in the intravitreal group. At week one the mean visual acuity improved by 4.4 letters in the systemically and by 3.6 letters in the intravitreally treated groups. At month three the mean visual acuity gain in the systemic group was with 6.9 letters (95% confidence interval, CI 3.91 to 9.39) identical to 6.9 letters in the intravitreal group (95% CI 2.83 to 10.90). Alike, CRT decreased by 130.0 µm (95% CI 37.81 to 222.19) and 134.9 µm (95% CI 46.05 to 223.75), respectively, after three months.
The initial functional and anatomic treatment response to intravitreal and systemic bevacizumab appears comparable. Further long–term follow–up is required to compare safety and durability of the different treatment modalities.
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