Randomised clinical trial of intravitreal Avastin vs photodynamic therapy and intravitreal triamcinolone: long-term results

Abstract

Purpose To compare 1-year functional and anatomic outcomes of intravitreal bevacizumab (IVB) and photodynamic therapy plus intravitreal triamcinolone (PDT þ IVTA) combination in patients with neovascular age-related macular degeneration (AMD). Methods In this prospective, randomised, controlled clinical trial, 28 patients were included. All patients were randomised 1 : 1 to 0.04 ml/1 mg of IVB or PDT plus same day 0.1 ml/4 mg IVTA (PDT þ IVTA). Follow-up examinations were performed in monthly intervals in IVB group and every 3 months in PDT þ IVTA group. Main outcomes were change in mean visual acuity (VA), mean central retinal thickness (CRT) and the mean number of treatments. Results At month 12, mean VA improved to a 1.5-line gain in IVB group, and lost three letters in PDT þ IVTA group (P ¼ 0.02). Mean CRT was reduced from 357 lm at baseline to 244 lm at month 12 in IVB group and from 326 lm to 254 lm, respectively, in PDT þ IVTA group (P ¼ 0.8). The mean number of treatments was 6.8 in the IVB group vs 1.9 in the PDT þ IVTA group. No significant local or systemic safety concerns were detected during follow-up time. Conclusions Patients treated with IVB showed a significant better VA outcome compared with the PDT þ IVTA group despite the fact that both modalities showed equal potency in reducing CRT during a 12-month period.

A retrospective analysis of low dose, intranasal injected bevacizumab (Avastin) in hereditary haemorrhagic telangiectasia

“…By contrast, the dose of 3.75 mg brought about signiWcant success. For Wnding an optimal dose, we referred to the local application of bevacizumab in Ophthalmology, where doses about 1-2 mg are used successfully for intravitreal injections [17]. As previously mentioned, 100 mg bevacizumab was used in another study in epistaxis in HHT [22,24] and intravenous applications of 5-10 mg per kilogram bevacizumab are described in case reports [25][26][27][28].…”

“…colorectal carcinoma, renal cell or breast cancer [15,16]. Bevacizumab is also used intensively and very successfully in ophthalmology for diseases involving neovascularization, such as age-related macular degeneration [17].…”

Bevacizumab for serous changes originating from a persistent branching vascular network following photodynamic therapy for polypoidal choroidal vasculopathy

“…In this study, the mean BCVA decreased from 0.24 (log-MAR 0.63) to 0.22 (logMAR 0.66), although this was not statistically significant. Numerous studies showed that intravitreal bevacizumab is efficacious in terms of visual acuity and anatomical improvements for the treatment of neovascular AMD [15][16][17][18][19][20]. Costagliola et al [19] report the results of intravitreal bevacizumab injections in 68 treatment-naïve patients with occult CNV.…”

Corticosteroids and Anti-Complement Therapy in Retinal Diseases

“…It was described for use initially systemically as an intravenous treatment (Michels et al 2005) and subsequently via off-label intravitreal administration for AMD (Avery et al 2006;Rich et al 2006). Prospective randomized controlled trials have proven the efficacy of bevacizumab in treating AMD (Sacu et al 2009;Tufail et al 2010), macular edema from CRVO , and diabetic macular edema (DME) in the BOLT trial (Rajendram et al 2012). …”