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V. Hamelmann, C. H. Meyer, S. E. Karl, H.-M. Helb, F. G. Holz, N. Eter; Intravitreal Bevacizumab Therapy for Pigment Epithelial Detachments in Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4559.
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To determine the effect of intravitreal Bevacizumab(Avastin) in patients with pigment epithelial detachments (PED) secondary to age-related macular degeneration (AMD).
39 eyes (38 patients) with PED due to neovascular AMD were treated with intravitreal Bevacizumab (1,5 mg). Baseline and follow-up visits included testing for ETDRS visual acuity and examination by optical coherence tomography (OCT 3, Zeiss, Oberkochen). Before treatment lesions were characterized by digital fluorescein angiography and OCT. The amount of PED was determined as the highest elevation on to perpendicular OCT cross sections. Review examinations were performed 4 weeks and 12 weeks after treatment.
On OCT, PED decreased from 341 µm (95% CI: 266, 417) at baseline to 197 µm (95% CI: 70, 326; p<0.001) at 4 weeks and 214 µm (95% CI: 79, 351; p<0.001) at 12 weeks. Hereby, in 5 eyes (16,7%) there was no alteration in vertical extension of the PED noted. Mean BCVA increased from a mean of 49 letters (95% CI: 40, 57) at baseline to 54 letters (95% CI: 41, 66; p=0.03) at week 4, however, 12 weeks after injection mean BCVA dropped below baseline level (mean 47,5 letters, 95% CI: 34, 54; p=0.6).Except for one RPE rip no other ocular or systemic adverse events were noticed. Ocular inflammation was not found in any of the investigated patients.
These data indicate a therapeutic effect of intravitreal Bevacizumab in presence of pigment epithelial detachments secondary to AMD. Preliminary analysis suggests that short term treatment response may be inferior to those observed in neovascular AMD without PED. Further studies are warranted to determine long-term effects and retreatment intervals.
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