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E. M. Medori, M. Contestabile, V. Fenicia, L. Fabrizio, A. Perdicchi, D. Iacovello, S. Amodeo, S. Recupero; Clinical, Structural (OCT), Electrophysiological (VEP, ERG), and Psychophysical (SAP and FDT) Evaluation Following Repeated Intravitreal Bevacizumab in Age Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2783.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate Optical Coherence Tomography (OCT), electrophysiological responses, and 10° central computerized visual field after two intravitreal injections of bevacizumab for the treatment of neovascular age-related macular degeneration (AMD).
Prospective, non-randomized, interventional case study. 10 eyes of 10 patients with subfoveal choroidal neovascularization (CNV) due to AMD received two intravitreal injection of Bevacizumab (Avastin) spaced a month. At the baseline and after one month from the first injection and one month from the second injection of Bevacizumab the patients underwent a complete ophthalmic examination and did the following exams : OCT scannings (CRT), Visual Evoked Potential (VEP), pattern and full field Electroretinography (PERG, ERG), 10° central visual field with achromatic computerized standard perimetry (Humphrey 750 10-2 SITA ) and with frequency doubling technology (Matrix 10-2 threshold test). The results were statistically processed using Statistical Software (SPSS\10.5, SPSS Inc, Chicago, Illinois, USA).
At baseline, mean visual acuity was 0.3 and showed improvement to mean 0.5 one month after the first injection. One month after the second injection the mean visual acuity was 0.6 (P ≤ 0.161). The mean central retinal thickness (CRT) was 352.1 µm at baseline and decreased to mean 259.2 µm at one month (P ≤0.041). At 2 months, mean CRT was 225 µm (P ≤0.002). VEP, PERG and ERG, did not show any statistically significant change in waveform parameters following intravitreal injection of bevacizumab. Also perimetric indices did not show any statistically significant difference at two months.
Intravitreal injection of bevacizumab resulted in a significant reduction in the central retinal thickness and in a moderate improvement of visual acuity. VEP,PERG and ERG responses obtained in all patients did not show any statistically significant change. These results suggest any toxic effect on the optic nerve conduction and on the general retinal function. The stability of central conventional and non conventional perimetry at all controls has shown that there was no clinically relevant loss of ganglion cells. No ocular or sistemic side effect was found. In conclusion, this study provides an additional insight of retinal safety after repeated intravitreal injections of bevacizumab in patients with CNV.
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