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S. Ahmad, C. C. Patel, T. H. Mahmoud, J. E. Puklin, G. W. Abrams; Treatment of AMD-Associated Subretinal Hemorrhage With Ranibizumab (Lucentis®) and Bevacizumab (Avastin®). Invest. Ophthalmol. Vis. Sci. 2008;49(13):320. doi: https://doi.org/.
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To assess the response of eyes with fovea-involving subretinal hemorrhage (SRH) associated with age-related macular degeneration (AMD) to treatment with either ranibizumab (Lucentis®) or bevacizumab (Avastin®).
A retrospective review was conducted of eyes with AMD that were consecutively treated in a non-randomized manner with either Avastin or Lucentis for fovea-involving subretinal hemorrhages. Eyes were excluded from study entry if the area of SRH comprised less than 50% of the total lesion size on fluorescein angiography (FA). Baseline data recorded included history of coumadin use, previous treatments for neovascular AMD, best-corrected visual acuity (BCVA), area of SRH (in mm2), and area of total lesion size on FA. Follow-up data recorded included BCVA, status of SRH, and complications.
Five eyes were identified with a mean post-treatment follow-up of 9.4 months. Mean pre-treatment VA was 20/1700, and mean SRH size was 20.1 mm2. Three eyes (60%) were treated with Avastin and two eyes (40%) were treated with Lucentis. The SRH resolved in all eyes after a mean of 5.8 months, with a mean VA of 20/700 at the time of SRH resolution. Of all eyes at the most recent follow-up visit, three eyes (60%) exhibited improved VA (greater than 2 lines), one eye (20%) exhibited worse VA, and one exhibited no change in VA. Mean VA for all eyes at most recent follow-up was 20/380.
Whereas the reported natural history of SRH in NVAMD indicates, approximately, a 20% rate of spontaneous VA improvement after 9 months, our study's results suggest treatment of AMD-associated fovea-involving SRH with either Avastin or Lucentis may provide better visual outcomes than observation alone. Further study is warranted in order to confirm these findings, and to explore a possible synergistic role for other treatment modalities.
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