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T. Diep, K. E. Stepien, S. Kieval; Bevacizumab (Avastin): Treatment of Retinal Disease in a Referral Retina Practice. Invest. Ophthalmol. Vis. Sci. 2007;48(13):285.
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To study the effects of intravitreal bevacizumab (Avastin; Genentech, Inc., South San Francisco, CA) on choroidal neovascularization (CNV) associated with age-related macular degeneration (ARMD), and macular edema associated with branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO), diabetic macular edema (DME) and cystoid macular edema (CME).
This was a retrospective review of 85 consecutive eyes with CNV associated with ARMD, or macular edema associated with BRVO, CRVO, DME, or postoperative CME. Treatment of these patients involved serial intravitreal injections of bevacizumab. Disease progression was evaluated using clinical examination, fluorescein angiography (FA), optical coherence tomography (OCT), and subjective measures. Main outcome measures were changes in visual acuity and OCT central retinal thickness. Other outcomes included changes in FA, clinical examination, and subjective findings, as well as ocular complications.
For patients with CNV associated with ARMD, mean visual acuity remained stable from 20/108 to 20/106. Mean OCT central retinal thickness decreased by 33 microns (p=0.005). Subjectively, 91% of patients felt their vision was at least stable, and 52% felt improved vision overall. For all patients with macular edema, mean visual acuity improved significantly (20/156 to 20/68, p=002) as did mean OCT central retinal thickness (decreased of 142 microns, p=0.012). Subjectively, 93% of patients felt their vision was at least stable, and 72% felt improved vision overall. Clinical findings by examination and FA also improved. Subgroup analysis showed that patients with macular edema associated with BRVO and CRVO had greater improvement than those with DME and CME.
Intravitreal bevacizumab was effective in stabilizing CNV associated with ARMD and was effective in reducing macular edema, especially from BRVO and CRVO.
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