Abstract
Purpose: :
To evaluate the functional and morphological treatment effects and safety of intravitreal bevacizumab (IVB) in patients with neovascular age-related macular degeneration (nAMD) 3 years after the initial IVB.
Methods: :
In this interventional clinical study, 181 eyes of 160 patients with each subtype of neovascular age-related macular degeneration were included and 3 years after the initial IVB, best-corrected visual acuity (BCVA) was measured using Snellen charts at 6m. Central retinal thickness (CRT) was measured using Stratus OCT and Cirrus SD-OCT (Zeiss). Data of treatment-naive eyes (group 1) were compared to the data of eyes that had undergone prior treatment (group 2). Retreatment was performed based on clinical outcome and following an optical coherence tomography (OCT)-based regimen. Systemic side effects s.a. thromboembolic disease, hypertensive encephalopathy as well as ocular complications were assessed during the follow-up period.
Results: :
In group 1, 114 eyes were followed-up whereas 67 eyes received PDT+IVTA pretreatment in group 2. BCVA significantly decreased in both groups 3 years after initial anti-VEGF therapy in comparison to baseline values (0.23 ± 0.20 to 0.16 ± 0.20 in group 1, p=0.005; 0.23 ± 0.19 to 0.16 ± 0.21 in group 2, p0.05). Mean treatment rate were 5.1± 3.9 IVB in group 1 versus 3.7±2.7 injections in group 2 (p=0.01). No cases of hypertensive encephalopathy or thromboembolic disease were detected after treatments.
Conclusions: :
Intravitreal anti-VEGF therapy with bevacizumab is a safe form of therapy for nAMD. However, compared to 1-year results the 3-year functional and morphological results are disappointing.
Clinical Trial: :
MUW EK 548/2009
Keywords: choroid: neovascularization • age-related macular degeneration • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials