Intravitreally administered bevacizumab (Avastin) in minimally classic and occult choroidal neovascularization secondary to age-related macular degeneration

Abstract

Short-term results suggest that intravitreally administered bevacizumab (Avastin) is effective in minimally classic and occult CNV due to AMD. Significant improvements in VA, CFT and TMV were obtained and maintained during follow-up. In some patients, however, recurrence of leakage requiring additional intravitreal injection occurred. Maintenance of the effect of bevacizumab and its safety after repeated and prolonged administration have to be investigated in well-controlled studies.

Verteporfin therapy in occult with no classic CNV due to AMD: results of the Photodynamic Therapy in Occult-Only Lesions study

“…20 There have also been reports of the full-length, monoclonal anti-VEGF antibody bevacizumab (Avastin s ; Genentech), which is approved for certain solid tumours (ie, metastatic colorectal cancer, non-small-cell lung cancer, breast cancer), administered as intravitreal injection in patients with neovascular AMD. [21][22][23][24][25][26][27][28] Findings from these small-scale, short-term, noncontrolled, non-randomized studies or case series have shown improvements in visual acuity of 3.1-7.4 letters from baseline over 1-12 months follow-up, as well as anatomical benefits, following bevacizumab. [21][22][23][24][25] Although bevacizumab was generally well tolerated, adverse events included endophthalmitis, retinal pigment epithelial tears, and submacular haemorrhage.…”

“…[21][22][23][24][25][26][27][28] Findings from these small-scale, short-term, noncontrolled, non-randomized studies or case series have shown improvements in visual acuity of 3.1-7.4 letters from baseline over 1-12 months follow-up, as well as anatomical benefits, following bevacizumab. [21][22][23][24][25] Although bevacizumab was generally well tolerated, adverse events included endophthalmitis, retinal pigment epithelial tears, and submacular haemorrhage. 21,26,28 The long-term efficacy and safety of bevacizumab in neovascular AMD have yet to be elucidated in large-scale, randomized, controlled trials.…”

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

“…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.…”

“…It has also been combined with intravitreal triamcinolone to permit more favorable results. Generally, results of PDT for subfoveal neovascular membranes have been limited to stabilization of the process and the visual acuity (1)(2)(5)(6) . Vascular endothelial growth factor (VEGF) has been proved to be important in the development of abnormal vessels and on the increase of its permeability in many pathological conditions.…”

“…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.…”