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J. F. Arevalo, J. G. Sanchez, L. Wu, M. H. Berrocal, A. A. Alezzandrini, N. Restrepo, M. Maia, M. E. Farah, M. Díaz-Llopis, Pan-American Collaborative Retina Study Group; Comparison of 2 Doses of Primary Intravitreal Bevacizumab for Subfoveal CNV in AMD at 24 Months: Results From the Pan-American Collaborative Retina Study Group. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1250.
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To report the 24-month anatomic and ETDRS best-corrected visual acuity (BCVA) response after primary intravitreal bevacizumab (Avastin) (1.25 mg or 2.5 mg) in patients with subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).
Retrospective multicenter interventional comparative case series. We reviewed the clinical records of 180 consecutive patients (207 eyes) with subfoveal CNV secondary to AMD. Patients were treated with at least one intravitreal injection of 1.25 mg (124 eyes [59.9%]) or 2.5 mg (83 eyes [40.1%]) of bevacizumab. Patients underwent ETDRS BCVA testing, ophthalmoscopic examination, optical coherence tomography (OCT), and fluorescein angiography (FA) at baseline, 1-, 3-, 6-, 12- and 24-month visits.
The mean age of our patients was 74.3 ± 7.5 years. The mean number of intravitreal bevacizumab (IVB) injections per eye was 5.1 (range: 1 to 24 injections). In the 1.25 mg group, baseline BCVA improved from 20/235, logarithm of the minimum angle of resolution (logMAR) 1.07 to 20/172, logMAR 0.92 at 24 months (P < 0.0001). Similar BCVA changes were observed in the 2.5 mg group. Central macular thickness (CMT) at baseline by OCT in the 1.25mg group had a mean of 308.4 ± 127.52 µm which was reduced to a mean of 269.35 ± 97.92 µm, 262.1 ± 94.81 µm, 264.03 ± 97.06 µm, 245.91 ± 89.52 µm, and 249.27 ± 89.14 µm at 1, 3, 6, 12, and 24 months, respectively (P < 0.0001). Similar changes were observed in the 2.5 mg group. In the 2.5 mg group, systemic complications included 2 (2.6%) cases of arterial hypertension, one (1.3%) stroke, and one (1.3%) death.
Primary IVB at doses of 1.25 to 2.5 mg seem to provide stability or improvement in BCVA, OCT, and FA in subfoveal CNV secondary to AMD at 24 months. Our results show no significant difference regarding BCVA between IVB at doses of 1.25 mg or 2.5 mg.
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