Abstract
Purpose::
to report our short-term experience with bevacizumab in the treatment of neovascular age-related macular degeneration (AMD) and recommend a new treatment strategy based on the reported findings.
Methods::
retrospective chart review of 29 eyes of 29 patients who received intravitreal bevacizumab for subfoveal neovascular AMD and completed twelve weeks of follow up after treatment. All treated patients received 1.25 mg of intravitreal bevacizumab. Ophthalmic assessment included best corrected Snellen visual acuity (BCVA), complete ocular examination, fluorescein angiography (FA), and optical coherence tomography (OCT). Injections were repeated only if no further improvement or worsening was observed after an initial favorable functional and/or anatomical response. Other forms of treatment were considered at the clinician’s discretion in eyes with no measurable response or worsening after bevacizumab.
Results::
29 treated eyes completed twelve weeks of follow up. The average BCVA improved from 20/148 at baseline to 20/106 at twelve weeks (p=0.041). Of the 29 eyes, 25 (86.2%) had stable or improved BCVA. Average mean central macular thickness measured by OCT improved from 351 µm at baseline to 278 µm at twelve weeks (p=0.003). Stabilization of vision and improved OCT central macular thickness were maintained for at least eight weeks following only a single injection in the majority of eyes. During the three months follow up, only five eyes (17.2%) required repeat injections, with only three (10.3%) requiring retreatment at eight weeks and none at four weeks. No significant ocular or systemic side effects were observed.
Conclusions::
This short term data suggests that bevacizumab appears to be a safe and effective treatment for neovascular AMD. Injections as frequent as every month do not appear to be necessary since the initial treatment effect appears to be maintained for at least eight weeks in almost all of our patients.
Keywords: age-related macular degeneration • clinical (human) or epidemiologic studies: outcomes/complications • retina