Purchase this article with an account.
M. H. Amaro, A. B. Roller; Intravitreal Ranibizumab and Bevacizumab for the Treatment of Nonsubfoveal Choroidal Neovascularization of the Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1884.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To investigate the efficacy of vascular endothelial growth factor-specific (VEGF) monoclonal antibodies in the treatment of choroidal neovascularization secondary to age-related macular degeneration (AMD) that does not extend beneath the foveal center (nonsubfoveal CNV), and to compare the results with the Macular Photocoagulation Study (MPS) results for treatment of similar lesions .T
he study design was a retrospective chart review of consecutive patients over a two-month period under active treatment with bevacizumab and/or ranibizumab for neovascular AMD. Included were patients with neovascularization within the macula that did not extend beneath the center of the foveal avascular zone, along with at least one large drusen (≥125µ) or many intermediate size (63-124µ) drusen. Best corrected Snellen visual acuity and optical coherence tomography (OCT) analysis of the central macular thickness was recorded for each visit. Serial injections of bevacizumab and/or ranibizumab were administered until there was resolution of subretinal fluid clinically or by OCT. Data over the entire follow-up period were analyzed for overall visual acuity and OCT changes. All patients had follow-up since diagnosis of at least 6 months (mean = 9.6 months).
Of thirteen included patients, eleven had reduction of retinal thickening in the area involved by the CNV. The remaining two patients did not have OCT data available but had no fluid or activity on clinical examination at last follow-up. One patient (8%) lost one line of vision; one (8%) remained stable, and eleven (84%) gained one or more lines of visual acuity. Three patients (23%) gained three or more lines. The average treatment outcome for all patients was a gain of 1.7 ±1.3 lines of Snellen acuity. Both therapeutic agents were effective, with an average gain of 1.6±0.6 lines for patients treated with bevacizumab, 1.5 ±1.9 lines gained for patients treated with ranibizumab and 2.5 ±0.7 lines gained in the two patients who received both agents over the course of their treatment.
The use of intravitreal anti-VEGF agents for nonsubfoveal CNV in the setting of AMD is effective and seems to be a vast improvement when compared to the MPS studies using laser photocoagulation for treatment of juxtafoveal and extrafoveal lesions. Our results are comparable to published results from large-scale trials of anti-VEGF therapy for subfoveal CNV. Our data support the idea that bevacizumab or ranibizumab appear to be the treatment of choice for AMD patients with nonsubfoveal CNV.
This PDF is available to Subscribers Only