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R.B. Rush, E. Holz; Intravitreal Bevacizumab Therapy for Neovascular Age Related Macular Degeneration: An Uncontrolled Open–Label Clinical Study of Safety and Efficacy . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4294.
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To assess the safety profile of intravitreal bevacizumab and to determine whether bevacizumab could improve optical coherence tomography, visual acuity, or fluorescin angiography outcomes in patients with neovascular age–related macular degeneration.
Five patients were enrolled in an uncontrolled open–label study to receive 1.0 mg of intravitreal bevacizumab. All patients had neovascular age–related macular degeneration that either had a poor response to photodynamic therapy, pegaptanib treatment, intravitreal steroid injections or a combination of the three therapies or patients who declined to have any of the treatments previously mentioned. Each patient had either optical coherence tomography or fluorescin angiography at one month follow up appointments; all patients were evaluated for signs of infection, glaucoma, progression of cataract, bleeding, and hypertension. The study is currently ongoing and intended to last from three to six months of follow up evaluation.
After four weeks of follow up visits, no systemic or ocular complications were encountered. At one month, four of the five patients responded favorably with improved macular appearance on optical coherence tomography and fluorescin angiography. Visual acuity remained stable or improved in four of the five patients. The one patient who did not respond favorably showed persistence of subretinal fluid and worsened visual acuity at one month. Interestingly enough, this patient reported improved vision initially which subsequently declined one week prior to follow up evaluation.
Intravitreal bevacizumab could provide a safe, effective, and economically feasible alternative for patients with neovascular age–related macular degeneration. A large randomized prospective study is needed to fully determine the safety and efficacy of intravitreal bevacizumab; further research is needed to determine the appropriate dose and duration of action of intravitreal bevacizumab.
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