Abstract
Purpose::
To compare functional and anatomic outcomes of intravitreal Bevacizumab (Avastin®) and verteporfin therapy combined with intravitreal triamcinolone in patients with neovascular age-related macular degeneration (AMD)
Methods::
Twenty-eight patients with neovascular AMD were enrolled in a prospective, randomized, controlled clinical trial. The protocol was approved by the ethics committee at the Medical University Vienna and was registered at the European Clinical Trial Database. All patients randomized to 1 mg of intravitreal bevacizumab (0.04ml) received 3 initial treatments at 4 weeks intervals. In further follow-up retreatment was based on optical coherence tomography (OCT). Patients randomized to standard verteporfin therapy received a same day intravitreal injection of 4mg triamcinolone (Kenalog ®). Retreatment was based on fluorescein angiography (FA) at 3 months intervals. Functional and anatomic results were evaluated using the Early Treatment Diabetic Retinopathy study (ETDRS) protocol vision charts, FA and OCT.
Results::
Baseline characteristics were comparable for both groups with regard to visual acuity (ETDRS), central retinal thickness (CRT) and CNV subtyp. At month 3 visual acuity increased in the bevacizumab group from 49.6 ± 17.6 letters (~ 20/100) at baseline to 58.8 ± 19.4 letters (~20/63) and decreased slightly in the verteporfin and intravitreal triamcinolone treated group from 40.5 ± 15.9 (~20/160) to 38.6 ± 21.3 (~20/160-1). Both groups showed similar results with regard to reduction in central retinal thickness (CRT) as measured by OCT. At month 3 CRT was reduced in the bevacizumab treated group from 358µm to 225µm and in the verteporfin and intravitreal triamcinolone treated group from 328µm to 213µm.
Conclusions::
Intravitreal bevacizumab showed promising short-term results in patients with neovascular AMD. Functional results appear not only to be dependent on reduction in CRT but also on the treatment modality used.
Clinical Trial::
European Clinical Trial Database No 2005-003132-21
Keywords: age-related macular degeneration • choroid: neovascularization • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials