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R. F. Oliveira, L. L. Sanitá, M. M. D. Missen, F. J. Novelli, M. J. Nóbrega; Intravitreal Bevacizumab for Choroidal Neovascularization in Age-Related Macular Degeneration: 30-Month Results. Invest. Ophthalmol. Vis. Sci. 2010;51(13):931.
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To evaluate the functional outcome and safety of intravitreal bevacizumab (Avastin®, Genentech) for the treatment of choroidal neovascularization (CNV) in age-related macular degeneration (AMD) at Sadalla Amin Ghanem Eye Hospital, Joinville, southern Brazil.
Retrospective, non-comparative, consecutive case series of 16 patients with CNV due to AMD who received at least one intravitreal injection of bevacizumab and completed a minimum follow-up of thirty months. Demographics, logMAR best-corrected visual acuity testing (BCVA), optical coherence tomography findings and number of injections were analysed. Cases with prior verteporfin photodynamic therapy, photocoagulation and intravitreal or periocular injections of triamcinolone or other anti-angiogenic drugs were excluded. After written informed consent was obtained, patients were treated with an intravitreal bevacizumab dose of 1,50 mg (0,06 ml) and examined every 30 to 90 days. Reinjections were performed if worsening was observed after an initial favorable functional response (PRN dosing).
Twenty eyes of 16 patients were included in this study (37,5% male, 62,5% female) with a mean age of 75 years-old (59-87 years); they received an average of 5 injections (range 1-12). After 30 months of the beginning of therapy, BVCA declined in 8 eyes (40%), improved in seven eyes (35%) and stabilized in 5 eyes (25%), with a mean variation from 1,00 logMAR before treatment to 0,91 logMAR at the last follow-up visit. Central macular thickness varied from 397 microns previous to treatment to 393 microns at the final examination. No significant ocular or systemic side effects were noted.
This study suggests that a 30-month PRN therapy with bevacizumab for CNV in AMD is safe. The functional results showed that 60% of patients had an improvement or stabilization in visual acuity. However, a large proportion of patients had a vision loss in spite of a close ophthalmological control and multiple intravitreal injections of bevacizumab.
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