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J. J. Nassaralla, Jr., B. R. A. Nassaralla; Intravitreal Bevacizumab for Choridal Neovascularization Secondary to Age-Related Macular Degeneration - 780 cases. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1873.
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To report the short term anatomic and visual acuity response after intravitreal injection of bevacizumab (Avastin, Roche, Rio de Janeiro, Brazil) in patients with choroidal neovascularization secondary to age-related macular degeneration.
We conducted a retrospective study of patients with choroidal neovascularization secondary to age-related macular degeneration who were treated with at least two (initial and one month after) intravitreal injection of 1.25 mg bevacizumab and had a follow-up of at least 2 months. Patients underwent Snellen visual acuity testing, optical coherence tomography (OCT) imaging and ophthalmoscopic examination at baseline and follow-up visits.
There were 642 patients with a mean age of 68.3 (± 10.8) years, and a mean visual acuity of 20/200 and a mean central foveal thickness of 348 (±234) microns. Most of the patients (36%) were failures by other means of treatment. At the one month follow-up the mean visual acuity improved to 20/125 (p<.001) and the mean central foveal thickness decreased to 231 (± 176) microns (p<0.002). And after 2 months follow-up the mean visual acuity improved to 20/100 (p<.001) and the mean central foveal thickness decreased to 202 (± 146) microns (p<0.001). Nine eyes who had a mild amount of intraocular inflammation, one patient had intraocular hemorrhage and one patient had infection following injection.
Initial treatment results of patients with choroidal neovascularization secondary to age-related macular degeneration did not reveal any short-term safety concerns. Short-term results suggest that intravitreal bevacizumab (1.25 mg) is well tolerated and was associated with improvement in visual acuity, decreased retinal thickness by OCT, and reduction in angiographic leakage in most patients, The number of patients in this pilot study was limited and the follow-up is too short to make any specific treatment recommendations, but the favorable short-term results suggest further study is needed.
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