Abstract
Purpose::
To monitor the visual acuity of patients with neovascular age-related macular degeneration treated with repeat doses of intraocular Avastin, over a period of one year.
Methods::
This is a retrospective study in which the visual acuity response of forty-two consecutive eyes treated with repeat doses of intra-ocular Avastin from August 2005 to October 2006 was measured. Over 90% of the patients were previously treated with thermal laser, ocular photodynamic therapy and/or pegaptanib (Macugen) and were refractory to further treatment. Consent was obtained on all patients prior to off-label use of intraocular Avastin. Complete eye examination including visual acuity, was performed at baseline and each follow-up visit. Fluorescein angiography was performed as needed. Patients were evaluated one week after the first injection for uveitis.
Results::
Patients received between 3-5 injections, the average being 4. Intervals between injections ranged between 2-3 months. Decision to administer Avastin was based on favorable response (improvement or no further deterioration) to the previous Avastin injection. None of the patients showed signs of uveitis. None of the patients experienced hypertension. There was a mean improvement in VA from 20/200 to 20/100 after one year. At the end of one year, 57% of patients treated showed an improvement of VA, 29% remained the same and 14% showed deterioration. This was not statistically significant at the 95 % confidence level (paired t-test= .078)
Conclusions::
Many of the patients in this study had failed previous treatments; it is likely that eyes that are more recent in onset with ARMD, and had not received previous treatment will do better. While the outcome was not statistically significant, there is a clear trend as noted in the mean improvement of VA from 20/200 to 20/100 after one year.
Keywords: age-related macular degeneration • retina • macula/fovea