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G. Belsare, S. Hariprasad, R. D. Jager, D. A. Mazzulla, W. Mieler; Effects on Visual Acuity and OCT Following Older Generation AMD Treatment With Subsequent Lucentis or Avastin Intravitreal Injections. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1443.
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The recent use of anti-VEGF therapies has shown promising results in patients with exudative age-related macular degeneration (AMD). Older therapies include photodynamic therapy (PDT) and pegaptanib(Macugen) whereas newer treatments include ranibizumab (Lucentis) or bevacizumab (Avastin). To our knowledge, this study will be the first to show changes in visual acuity and macular thickness on OCT when transitioning from older to newer exudative AMD treatments. We hypothesize that both visual acuity and macular thickness will improve after a new generation treatment has been initiated.
We conducted a retrospective chart review of subjects receiving Lucentis or Avastin after PDT or Macugen treatment. Their visual acuity and OCT results were compared before and after the newer generation treatment. Three groups were studied: 1) Macugen to Lucentis; 2) Macugen to Avastin; 3) PDT to Avastin.
In group 1(n=4) all subjects had exudative AMD. The average visual acuity (VA) change after Macugen to Lucentis treatment was 20/250 to 20/110 (p=0.1). Macular thickness decreased from 324 mm to 230 mm(p=0.38). Group 2(n=9) consisted of two subjects with polypoidal choroidopathy, one with CNV due to high myopia and seven with exudative AMD. The average VA improved from 20/570 to 20/360(p=0.32). Macular thickness increased from 275 mm to 307 mm(p=0.67). Group 3 (n=7) had one subject with angioid streaks and six patients with exudative AMD. VA significantly improved from 20/500 to 20/240(p=0.04). Macular thickness decreased from 310 mm to 260 mm(p=0.08).
Short-term results reveal a trend that intravitreally administered Avastin and Lucentis are effective in producing further visual gains in exudative AMD, polypoidal choroidopathy and CNV due to high myopia in patients previously treated with older generation AMD therapies.
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