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M. J. Tolentino, M. Bennett, D. Misch, A. Berger, S. J. Moon, R. Hamilton; Avastin Enhancement or Induction Followed by Macugen Maintenance for Exudative AMD. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1969.
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To determine the efficacy of bevacizumab (Avastin) to enhance pegaptanib (Macugen) maintenance therapy either as an induction administration or as a booster therapy.
Patients with CNV secondary to AMD who received an intravitreal injection of 1.25 mg of Avastin within 6 weeks of a macugen injection either as an induction dose or as a booster dose while on Macugen maintenance therapy were retrospectively analyzed. Patients were included into the study if there was at least 3 months of follow-up with at least baseline 3 and 6 month OCTs performed. Snellen visual acuity, number of subsequent Avastin injections, change in OCT thickness and adverse events were used as primary and secondary endpoints.
52 eyes had 3 month follow-up, 31 eyes had more than 6 month follow-up. 51/52(98%) of eyes at the 3 month timepoint and 31/31(100%) eyes at the 6 month timepoint did not lose more than 3 lines of vision. 45/52 (86%) of eyes at 3 months and 30/31 (97%) of eyes at 6 months gained or had no change in vision. 18/52(35%) eyes at 3 months and 14/31 (45%) at 6 months gained 3 or more lines of vision. An average of 8 snellen letters were gained at 3 months and 14 snellen letters at 6 months. Average OCT thickness was reduced by 85 um at 3 months 124 um at 6 months. An average of 1 Avastin injection was given at 3 months and 1.2 Avastin injections were given at 6 months. Adverse events included stroke after Avastin injection, anaphylactic reaction to Avastin, and uveitis afer Avastin injection.
Using Avastin as either an induction dose or as a booster therapy resulted in improved vision at 3 months and more visual improvement in patients who had at least 6 months of follow-up. This study supports the need for further study of this treatment combination.
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