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W. R. Freeman, I. Falkenstein, L. Cheng, V. L. Morrison, I. Kozak, A. M. Tammewar; ETDRS Vision Results of Primary Avastin (Bevacizumab) for CNV in ARMD versus Avastin Rescue After Macugen (Pegaptanib) Therapy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2873.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the ETDRS visual outcomes and OCT results of primary Avastin therapy for CNV in ARMD with Avastin "rescue" after multiple prior Macugen treatments for persistent CNV activity.Methods and
We analyzed two longitudinal cohorts. Primary Avastin cohort: 18 eyes of 18 patients underwent an average of 3.4 consecutive injections of primary Avastin treatment. Avastin post Macugen cohort: 20 eyes of 20 patients underwent an average of 4.2 consecutive injections of Macugen as the initial treatment for ARMD followed by an average of 3.6 injection of Avastin. In both cohorts Avastin was injected every 6 weeks, 1.25 mg per injection. Visual acuity was measured with ETDRS chart. Analysis of 3 month data was performed on all eyes and follow up continued for up to 6 months. Primary outcome measures were ETDRS visual acuity change and macular thickness change measured by OCT.
Mean visual acuity improvement in the primary Avastin group was 1.5 ETDRS lines at 3 months (p=0.0009) and 3.7 ETDRS lines at 6 months (p=0.0012) compared to 0.4 ETDRS lines at 3 months (p=0.22) and 0.3 ETDRS lines at 6 months (p=0.67) in the Avastin post Macugen group. The mean change in retinal thickness was greater in the primary Avastin eyes 81.5 µm (p= 0.0051) versus 39.9 µm in the Avastin post Macugen group (p=0.27).
Primary Avastin therapy for CNV in ARMD results in 2-3 ETDRS lines of improvement, which is similar to Lucentis. Avastin "rescue" (Avastin post Macugen) results in minimal improvement. This report using standardized ETDRS refracted visual acuity documents efficacy of Avastin in improving vision in CNV in ARMD.
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