Efficacy of intravitreal bevacizumab (Avastin^®) therapy for early and advanced neovascular age‐related macular degeneration

Abstract

. Purpose: To evaluate the safety and efficacy of intravitreal bevacizumab therapy for early and advanced neovascular age‐related macular degeneration (ARMD). Methods: A consecutive series of eyes with neovascular ARMD treated with monthly intravitreal injections of bevacizumab (1.25 mg/0.05 ml) as long as there was evidence of activity on fluorescein angiography (FA) and optical coherence tomography (OCT) was included and observed for 6 months. For further analysis they were assigned to either an early (untreated/newly diagnosed) or an advanced (predominantly fibrotic/pre‐treated) ARMD group. We examined distance visual acuity (VA) with Early Treatment Diabetic Retinopathy Study (ETDRS) charts and central retinal thickness with OCT, as well as lesion size and safety aspects. Results: Forty‐four patients (44 eyes) were enrolled (21 early lesions, 23 advanced lesions). Mean VA changed from 0.74 logMAR at baseline to 0.68 logMAR at month 6 (P = 0.01). Improvement in VA was statistically significant only in eyes with early lesions (n = 21) from month 1 (P = 0.015) up to month 6 (P = 0.03). The changes in central retinal thickness (CRT) (P < 0.001) and total lesion size (P < 0.001) were significant in both groups (early and advanced) at all time‐points during follow‐up. No significant ocular or systemic adverse effects were observed. Conclusion: Intravitreal bevacizumab was tolerated well by our patients and we did not identify any apparent short‐term safety concerns. We observed stabilization in VA overall, with significant improvement in the early lesion group.

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

“…None of the CNV lesions that reacted positively to the treatment exhibited prior subfoveal fibrosis. This is in accordance with the findings of the studies by Krebs et al (2009) and Algvere et al (2008). Both studies compared the effect of bevacizumab in the treatment of early and advanced AMD and observed a statistically significant improvement in the early lesions only.…”

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

“…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.…”

Prevention of Corneal Neovascularization: Comparison of Different Doses of Subconjunctival Bevacizumab with Its Topical Form in Experimental Rats

“…Its systemic and intravitreal forms have been used for prevention and treatment of different conditions, like age-related macular degeneration [10,11] , proliferative and nonproliferative diabetic retinopathy [12,13] , neovascular glaucoma [14] and, recently, CNV [15] .…”