Bevacizumab (AvastinTM) Non-responding in Therapy of Choroidal Neovascular Lesions

Abstract

Purpose:: Reasons for "non-responders" to bevacicumab intravitreal treatment in CNV are to be investigated.

Methods:: Bevacizumab intravitreal injections of 1.25 mg (0.05ml) were performed in 52 eyes with visual loss due to choroidal neovascularization The follow up was every 4 weeks, for a period of 2, 3 or 6 months. Re-injection was performed depending leakage of the membrane as determined by fluorescein angiography and OCT imaging. Non-responders were defined as reduced or stable VA at the last follow up.

Results:: 44% percent of the patients were non-responders. In this group the initial CNV size was significantly larger than in the benefiting group. The initial reading ability was significantly lower and the initial foveal edema was similar in both groups. A gain in mean VA and reading ability was independent of the lesion type. The proportion of non-responders to benefiting patients in the different lesion type groups was equally distributed except for mainly benefiting classic membranes.

Conclusions:: In this study first reasons for "non-responders" to bevacicumab intravitreal treatment in CNV could be revealed. The efficiency of bevacizumab depends on the initial lesion size and the initial reading ability, while being independent of the initial foveal edema. There was no general ineffectiveness of bevacizumab to a certain lesion type.

Keywords: age-related macular degeneration • choroid: neovascularization • growth factors/growth factor receptors