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S. Aisenbrey, Tuebingen Bevacizumab Study Group; Intravitreal Bevacizumab (AvastinTM) for Neovascular Age–Related Macular Degeneration (AMD) . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5215.
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To evaluate short–term treatment effects on visual acuity and central retinal thickness following intravitreal bevacizumab (AvastinTM) therapy in patients with subfoveal choroidal neovascularization (CNV) secondary to age–related macular degeneration (AMD).
Twenty–five patients with subfoveal occult CNV have been enrolled in this prospective, open–label, uncontrolled clinical study. Each patient received one intravitreal injection of bevacizumab (1,0mg AvastinTM) and monthly subsequent injections if an increase in central retinal thickness (CRT) and/or persistent leakage in fluorescein angiography were observed. Intraocular injection was performed in topical anaesthesia under sterile conditions via pars plana intravitreally. At baseline and determined follow–up visits patients had medical review, ETDRS visual acuity assessment, ophthalmological examination, intraocular pressure measurement (IOP), fluorescein angiography, and optical coherence tomography imaging (OCT).
Of the 25 patients enrolled 20 presented with occult CNV including fibrovascular pigment epithelium detachment (PED), three with retinal angiomatous proliferation, and two with pigment epithelial rip. Fluorescein leakage decreased significantly within 1 week and improvement was maintained for at least 4 weeks after application. OCT revealed significant decrease of CRT after 1 week and 4 weeks respectively (mean change 175µm). Visual acuity improved or remained stable in all patients (mean change 1.4 lines); improvement of more than 2 lines was seen in 5 of 25 patients. Significant raise of IOP was not detected in any patient; none of the patients developed signs of endophthalmitis.
Intravitreal injection of bevacizumab (AvastinTM) may provide a novel medical treatment alternative for selected patients with exudative AMD. Randomized prospective multicenter trials seem justified to further evaluate long term effects and impact on different subtypes of AMD compared to established therapies.
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