Efficacy of 12-month treatment of neovascular age-related macular degeneration with intravitreal bevacizumab based on individually determined injection strategies after three consecutive monthly injections

Abstract

ABSTRACT.Purpose: To report the results of intravitreal treatment with bevacizumab in neovascular age-related macular degeneration (AMD) after a loading dose (LD) of three monthly injections followed by an optical coherence tomography (OCT)-guided strategy, based on best-corrected visual acuity (VA) and number of injections required over 1 year.Methods: A series of consecutive cases of 149 eyes of 147 patients received three or more intravitreal injections of bevacizumab (1.25 mg) for neovascular AMD over a 1-year period. The patients underwent ophthalmological examinations: measurement of the VA, fluorescein angiography, dilated fundus examination at baseline; VA, OCT and dilated fundus examination at monthly follow-up visits. Repeated injections were given each month for the first 3 months (LD); thereafter, injections were only administered if leakage or macular oedema were present.Results: Mean baseline VA was 51 ± 14 letters, which improved to 58 ± 15 letters (p < 0.0001; n = 149) at first evaluation (15 ± 2 weeks), 59 ± 15 letters (p < 0.0001; n = 143) at second evaluation (25 ± 2 weeks) and 57 ± 16 letters (p < 0.0001; n = 132) at third evaluation (51 ± 3 weeks). The baseline mean central retinal thickness (344.6 lm) and total macular volume (8.6 mm 3 ) decreased at first evaluation, to 219.0 lm (p < 0.0001) and 7.2 mm 3 (p < 0.0001), respectively. The mean number of injections per patient treated for 1 year was 5.1 (range 3-9). No systemic side-effects were noted. Conclusion:Treatment of neovascular AMD with intravitreal bevacizumab administered in LD of three monthly injections and followed by an OCT-guided strategy provides functional and anatomical improvements for up to 1 year.

Bilateral Intravitreal Bevacizumab Injection for Exudative Age-Related Macular Degeneration: Effect of Baseline Visual Acuity

“…This conclusion, however, should not lead to a delay in the treatment of the better-seeing eye, as the therapeutic efficacy of the intravitreal anti-vascular endothelial growth has been proved. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] …”

“…1 After the introduction of intravitreally applied bevacizumab into clinical ophthalmology by Rosenfeld and colleagues, 2 intravitreal bevacizumab has become one of the pillars in the therapy of exudative AMD. [3][4][5][6][7][8][9][10] Despite numerous studies on the effect of intravitreal bevacizumab on visual outcome in patients with exudative AMD, studies based on clinical practice with a consecutive inclusion of patients and an analysis of factors influencing the postinjection outcome have been mostly missing so far. It was, therefore, the purpose of our study to evaluate, in an intraindividual intereye comparison, whether baseline visual acuity and baseline anatomic macular changes influence visual outcome in patients bilaterally receiving intravitreal bevacizumab as treatment of exudative AMD in clinical practice.…”

Comparison of the effect between pegaptanib and ranibizumab on exudative age-related macular degeneration with small lesion size

“…Currently, anti-VEGF therapies are the leading modalities for exudative AMD 15–17. Many reports demonstrated that IVR remarkably attenuated the activity of CNV and improved the average visual outcome.…”

Intravitreal Bevacizumab Treatment for Exudative Age-Related Macular Degeneration With Good Visual Acuity

“…Mean initial IOP was 14.2 ± 2.4 mmHg (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22), and mean final IOP was 14.3 ± 2.45 mmHg (10-22) (P = 0.94, one-way ANOVA). Four eyes (2 with juxtafoveal CNV and 2 with subfoveal CNV), acquired either glaucoma or ocular hypertension, with an IOP between 22 mmHg and 28 mmHg at diagnosis (mean …”