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K.D. Rosenberg, P.J. Rosenfeld, C.A. Puliafito, S. Michels, A.A. Moshfeghi, A.E. Fung; Indocyanine Green Angiographic Outcomes Following Systemic Bevacizumab (Avastin®) Therapy for Neovascular Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1377.
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Purpose: To assess the change in appearance of subfoveal choroidal neovascularization (CNV) using indocyanine green angiography (ICGA) following systemic bevacizumab (Avastin®, Genentech Inc.) therapy in patients with age–related macular degeneration (AMD). Methods: AMD patients with subfoveal CNV, a central retinal thickness of at least 300 microns, and visual acuity from 20/40 to 20/400 were enrolled in a prospective, open–label, single–center, uncontrolled clinical study. They were treated initially with 2 or 3 infusions of bevacizumab (5mg/kg) at 2 week intervals. Patients were examined every week for the first 6 weeks, every 2 weeks for the next 6 weeks, and every 4 weeks thereafter. At baseline and every 12 weeks, ICGA was performed. Angiographic outcomes included the change in lesion size and appearance of hot spots, plaques, and hypofluorescent areas. Results:Of the 15 patients enrolled in the study, 9 patients have been followed for at least 12 weeks. Of the 9 patients, 8 patients had evidence of CNV in both eyes at baseline. In the 9 Study Eyes and the 8 Fellow eyes with evidence of subfoveal CNV, all hot spots identified by ICGA at baseline were absent by 12 weeks of follow–up. In addition, the borders of all plaques were better delineated by 3 months. There was no evidence of lesion growth and no change in the areas of hypofluorescence after 12 weeks. Conclusions: Bevacizumab therapy resulted in the absence of hot spots and better delineation of plaques with no lesion growth detected after 3 months. Follow–up is ongoing to determine the durability of these favorable angiographic findings.
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