Comparing outcomes in patients with subfoveal choroidal neovascularization secondary to age-related macular degeneration treated with two different doses of primary intravitreal bevacizumab: results of the pan-american collaborative retina study group (PACORES) at the 12-month follow-up

Abstract

There were no statistically significant differences between the two dose groups with regard to the number of injections, anatomic and VA outcomes.

Current Knowledge and Trends in Age-Related Macular Degeneration

“…Although most of them were nonfoveal, it is unclear the impact this might have on the future. [70][71][72][73] The pooled data from various reports indicate a dose-dependent response to the drug, because at higher doses, the drug seems to have a better response. It is possibly the antiangiogenic agent most widely used worldwide, even though it was not developed for ophthalmologic use (Avastin; Genentech/ Roche, Inc, San Francisco, CA).…”

Causes of interruption of bevacizumab therapy in age-related macular degeneration

“…Since 2006, the use of off-label intravitreal therapy with bevacizumab, an anti-VEGF humanized monoclonal antibody, has greatly expanded throughout the world. It combines effectiveness, safety and cost facilities (7,9,12,(17)(18) . Despite the favorable results of bevacizumab in a significant number of patients with exudative AMD, its small intravitreal half-life usually limits its effect.…”

“…The occurrence of AMD increases with age, so it is expected to become more prevalent in developed countries as life expectancy continues to increase (1)(2)(3)(4)(5) . Although exudative (or neovascular) AMD is less common than dry AMD, occurring in approximately 10 to 20% of the patients, it is usually responsible for most severe cases of vision loss (1,(6)(7) . Choroidal neovascularization (CNV), the abnormal growth of new blood vessels from choriocapillaris into the subretinal space, is the hallmark of exudative AMD and its treatment has been challenging researchers and specialists during the last decades.…”

“…With greater understanding of the role of VEGF in the pathogenesis of neovascular AMD, drugs inhibiting the bioactivity of VEGF have been developed and introduced in the clinical setting. Nowadays, intravitreal anti-VEGF represents a new paradigm in exudative AMD therapy due to its better outcomes (1)(2)(3)(4)7,(9)(10) . Bevacizumab (Avastin ® ) is a recombinant humanized fulllength anti-VEGF derived from a murine antibody with a molecular weight of 148 kD.…”

“…It has also been frequently and successfully used as an off-label intravitreal treatment of neovascular AMD since 2006. Bevacizumab has a longer halflife than ranibizumab, the actual most efficient anti-VEGF approved by ANVISA for AMD treatment, and is supposed to require less frequent dosing (1)(2)(3)(4)(5)(6)(7)(10)(11)(12) . Despite the better visual results achieved with bevacizumab therapy for choroidal neovascularization, its benefits seem to be temporary.…”