Fluorescein Angiographic Outcomes Following Systemic Bevacizumab (Avastin®) Therapy for Neovascular Age–Related Macular Degeneration

Abstract

Abstract: : Purpose: To assess the change in the fluorescein angiographic appearance of subfoveal choroidal neovascularization (CNV) in patients with age–related macular degeneration (AMD) following systemic bevacizumab (Avastin®, Genentech Inc.) therapy. 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 4 weeks, FA was performed. Angiographic outcomes included the change in lesion size and leakage from CNV. Results: Of the 15 patients enrolled in the study, 13 patients have been followed for at least 1 month and 9 patients have been followed for at least 3 months. After 1 month, there was an absence or a marked reduction of fluorescein angiographic leakage from CNV in the Study Eyes from these first 13 patients. By 3 months, only 1 of the 9 eyes showed evidence of recurrent fluorescein angiographic leakage from CNV, but this recurrent leakage resolved by 4 months of follow–up. In the 12 Fellow Eyes with evidence of subfoveal CNV, leakage from CNV was markedly reduced, however the presence of fibrotic scars precluded an accurate assessment of leakage in all eyes. No growth was detected in any of the lesions. Conclusions: Bevacizumab therapy resulted in the absence or marked reduction of leakage from CNV as assessed by FA during the first 3 to 4 months. No lesion growth was detected. Follow–up is ongoing to determine the durability of these favorable angiographic findings.

Keywords: choroid: neovascularization • age-related macular degeneration • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled