Verteporfin Therapy and Intravitreal Bevacizumab Combined and Alone in Choroidal Neovascularization due to Age-Related Macular Degeneration

Lazić, Ratimir; Gabrić, Nikica

doi:10.1016/j.ophtha.2007.03.006

Cited by 136 publications

(109 citation statements)

References 19 publications

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“…The three RCTs all showed that bevacizumab is more effective than PDT (with or without triamcinolone) [9,27,31]. The RCTs were of a poor-to-reasonable quality and lack of masking was the main methodological problem.…”

Section: Resultsmentioning

confidence: 98%

“…Ultimately, 26 out of these 561 were suitable and used in the analysis. Three randomised controlled trials were published and presented separately [9,27,31]. We also combined in this review the data of the patients of these three RCTs who had received only intravitreal bevacizumab, and the data of patients of 23 before-and-after studies with follow-up of patients who had received bevacizumab for exudative AMD (Tables 2, 3, 4 and 5) [1-4, 7-10, 15-18, 23, 25, 27, 29, 30-35, 37, 40, 41, 48].…”

Section: Resultsmentioning

confidence: 99%

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A systematic review on the effect of bevacizumab in exudative age-related macular degeneration

Schouten

Heij

Webers

et al. 2008

Graefes Arch Clin Exp Ophthalmol

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Aim To provide evidence for the effect of bevacizumab on visual acuity (VA) and central retinal thickness (CRT) in exudative age-related macular degeneration Methods A systematic review of all articles of bevacizumab for exudative AMD was conducted. Articles published up to March 2008 were identified in Medline, Embase, the Cochrane Controlled Trials Register and references from included articles. Search terms were "Bevacizumab or Avastin" and "Macula* or ARMD or AMD or intra(-) vitreal or intra(-)vitreous". Three observers participated in the data retrieval and assignment of the quality scores. Results A total of 561 articles were retrieved. Three randomised controlled trials (RCT) and 23 before-and-after studies of patients (n=1,435) who had received bevacizumab were published. Inclusion criteria varied. Lack of masking was the main methodological shortcoming. These RCTs showed that bevacizumab is more effective than PDT. Bevacizumab was given intravenously or as intravitreal injection. The latter was given once, or repeatedly every 4 weeks, and with or without additional injection when a recurrence occurred, mostly based on visual acuity and/or findings from optical coherence tomography. After intravenous administration, the weighted mean change in VA was +12.8 ETDRS letters (range +11 to +14) and the weighted mean change for CRT was −129 μm (range −100 to −202). For the 23 studies with intravitreal injections, the change in VA was +8.6 letters (range +2 to +26) and the change in CRT was −90 μm (range −46 to −190). The incidence of adverse events was low. The change in VA was 2.7 letters higher for studies with a higher quality vs lower quality. Conclusion Visual acuity improves and central retinal thickness decreases in patients with exudative AMD after bevacizumab. There is no reasonable doubt that this is caused by bevacizumab. It is likely that a randomised controlled trial will show that bevacizumab is equivalent in effect to ranibizumab, which showed a change in ETDRS of +5.9 letters for occult or minimally classic CNV and +9.8 letters for classic CNV after three monthly injections in two large RCTs.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

A systematic review on the effect of bevacizumab in exudative age-related macular degeneration

Schouten

Heij

Webers

et al. 2008

Graefes Arch Clin Exp Ophthalmol

View full text Add to dashboard Cite

show abstract

“…The most common combination tried was with PDT. 17,18,22,23,32,35,49,50,54,61,66 Intravitreal bevacizumab was administered at the same session to up to 14 days post-PDT. The mean number of PDT sessions required at 6 months was 1.4 and the average intravitreal bevacizumab therapy was 2 (range 1-4) at 6 months.…”

Section: Combination Treatmentsmentioning

confidence: 99%

“…The mean gain in vision was þ 8.85 which is similar to that obtained in the RCT by Laziae et al and superior to intravitreal bevacizumab monotherapy. 51 One small Bevacizumab for age-related macular degeneration S Jyothi et al series assessed the effects of triple therapy (intravitreal triamcinolone, PDT and bevacizumab) and þ 17 letters gain was noted at 6 months. 17 A larger series by Augustin et al 23 studied 104 eyes treated with PDT, intravitreal dexamethasone and bevacizumab, and oral minocycline, and obtained a mean improvement of þ 8 letters at 10 months with a low number of retreatments.…”

Section: Combination Treatmentsmentioning

confidence: 99%

Intravitreal bevacizumab (Avastin) for age-related macular degeneration: a critical analysis of literature

Jyothi

Chowdhury

Elagouz

et al. 2009

Eye

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Purpose The current medical environment demands that quality health care is delivered at an affordable cost through the use of objective, unbiased clinical data. This study was undertaken to review the current literature on bevacizumab for age-related macular degeneration and its value in determining best clinical practice. Methods Randomised controlled trials (RCTs) and observational studies that met the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria were identified from the current literature for further analysis. Data concerning treatment dosing regimens, response to treatment, complications, and factors influencing outcome and safety were extracted and compiled into a database. Results As of January 2009, there were 5 RCTs that compared the outcomes of bevacizumab to other treatment options and 50 studies that met the STROBE criteria with similar visual and anatomical outcomes between RCTs and observational studies. Although the doses and dosing frequencies varied between the studies, the mean gain in vision at 3 months was þ 7.76±5.4 ETDRS letters (range þ 2 to þ 14.4); an effect that was maintained at 6 months in studies with longer follow-up. Predominantly classic lesions were the most responsive of all lesion subtypes. The complication profiles/rates were similar to those reported with other anti-vascular endothelial agents. Conclusions There is sufficient scientific and statistical evidence to advocate the effective use of OCT-guided administration of intravitreal bevacizumab for neovascular AMD. This is reflected in our study outcome measures that are comparable to findings published from recent well-conducted RCTs on intravitreal ranibizumab at the same time point.

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“…5 The function of anti-VEGF and photodynamic therapy (PDT) as a potential alternative to laser treatment in such cases was evaluated to determine if improved outcomes might be expected with these treatments. Although this approach has been reported for subfoveal lesions, [6][7][8] few if any reports exist for juxtafoveal or extrafoveal lesions.…”

Section: Introductionmentioning

confidence: 99%

Combined intravitreal anti-VEGF and verteporfin photodynamic therapy for juxtafoveal and extrafoveal choroidal neovascularization as an alternative to laser photocoagulation

Han

McAllister

Weinberg

et al. 2009

Eye

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Verteporfin Therapy and Intravitreal Bevacizumab Combined and Alone in Choroidal Neovascularization due to Age-Related Macular Degeneration

Cited by 136 publications

References 19 publications

A systematic review on the effect of bevacizumab in exudative age-related macular degeneration

A systematic review on the effect of bevacizumab in exudative age-related macular degeneration

Intravitreal bevacizumab (Avastin) for age-related macular degeneration: a critical analysis of literature

Combined intravitreal anti-VEGF and verteporfin photodynamic therapy for juxtafoveal and extrafoveal choroidal neovascularization as an alternative to laser photocoagulation

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