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INTRAVITREAL BEVACIZUMAB IN THE MANAGEMENT OF NEOVASCULAR AGE-RELATED MACULAR DEGENERATION: Effect of Baseline Visual Acuity

El-Mollayess, Georges M. MD*; Mahfoud, Ziyad PhD; Schakal, Alexandre R. MD; Salti, Haytham I. MD*; Jaafar, Dalida BS*; Bashshur, Ziad F. MD*

doi: 10.1097/IAE.0b013e3182877a0d
Original Study

Purpose: To study prospectively the safety and efficacy of intravitreal bevacizumab for eyes with neovascular age-related macular degeneration with baseline visual acuity better than 70 letters (Snellen equivalent better than 20/40).

Methods: Patients with treatment-naive neovascular age-related macular degeneration were categorized prospectively into three groups according to baseline visual acuity: Group 1 (better than 70 letters), Group 2 (70 to 61 letters), and Group 3 (60 to 51 letters). Best-corrected visual acuity and central retinal thickness using optical coherence tomography were measured at baseline and at each follow-up visit. Intravitreal bevacizumab was administered according to an as-needed optical coherence tomography–guided regimen. Main outcome measure was mean best-corrected visual acuity for each group at 12 months.

Results: Each group included 30 patients (30 eyes). Improvement in central retinal thickness was similar among the 3 groups (P = 0.964). Mean letter gain in visual acuity at 12 months was +0.4, +3.8, and +4.2 for Groups 1, 2, and 3, respectively (P = 0.42). Mean best-corrected visual acuity at 12 months was 78.4 letters for Group 1, 70.0 letters for Group 2, and 61.1 letters for Group 3 (P < 0.001). All eyes in Group 1 (100%) avoided losing 15 letters of best-corrected visual acuity versus 83.3% in Group 2 and 80.0% in Group 3. This difference was significant only between Group 1 and Group 3 (P = 0.02).

Conclusion: Intravitreal bevacizumab for eyes with neovascular age-related macular degeneration and baseline visual acuity better than 70 letters was safe and able to maintain this vision over 12 months.

Eyes with neovascular age-related macular degeneration were categorized into three groups according to baseline visual acuity. Intravitreal bevacizumab was administered on an as-needed basis. By 12 months, the group with a mean baseline visual acuity of >70 letters achieved a better visual outcome than eyes with worse baseline visual acuity.

*Department of Ophthalmology, American University of Beirut, Beirut, Lebanon;

Department of Public Health, Weill Cornell Medical College, Doha, Qatar; and

Department of Ophthalmology, Hotel Dieu de France, Saint Joseph’s University, Beirut, Lebanon.

Reprint requests: Ziad F. Bashshur, MD, American University of Beirut Medical Center, P.O. Box 11-0236/B11, Beirut, Lebanon; e-mail: zb00@aub.edu.lb

Supported by the University Research Board at the American University of Beirut.

The authors have no financial interest in any product mentioned in this study.

© 2013 by Ophthalmic Communications Society, Inc.