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VISUAL IMPROVEMENT FOLLOWING INTRAVITREAL BEVACIZUMAB (AVASTIN) IN EXUDATIVE AGE-RELATED MACULAR DEGENERATION

YOGANATHAN, PRADEEPA MD*; DERAMO, VINCENT A. MD*†; LAI, JAMES C. MD*†; TIBREWALA, RAJEN K. DESc; FASTENBERG, DAVID M. MD*†

doi: 10.1097/01.iae.0000244380.34082.67
Original Articles
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Purpose: To study the visual and anatomic outcome of intravitreal bevacizumab injection in the treatment of exudative age-related macular degeneration (AMD).

Methods: Retrospective review of patients who received one or more intravitreal bevacizumab injections for exudative AMD. Outcome measures include standardized visual acuity, optical coherence tomography (OCT), macular thickness and volume, intraocular pressure, and blood pressure at 24 or more weeks follow-up.

Results: Fifty eyes of 48 patients were identified. Patients were observed for a median length of follow-up of 34 weeks (range, 24–50 weeks). Thirty-six eyes (72%) had prior treatment with pegaptanib (Macugen) and/or photodynamic therapy (PDT) and 14 eyes (28%) were treatment-naive. Mean visual acuity increased by 6.5 letters (P < 0.01) at 4 weeks and 5.3 letters (P < 0.01) at 24 weeks after initial bevacizumab injection. At 24 weeks, naive eyes had a mean increase of 14.2 letters (P < 0.001) and previously treated eyes had a mean increase of 2.8 letters (P = 0.06). Overall, mean OCT macular thickness and volume decreased by 73 μm (P < 0.001) and 1.0 mm3 (P < 0.001) respectively at last follow-up. At last follow-up, all eyes received an average of 3.5 injections and experienced an average of 1.08 recurrences. There was no incidence of severe vision loss or adverse effect.

Conclusion: Intravitreal bevacizumab has the potential for improvement in vision in both naive and previously treated eyes for at least 6 months. The benefit is more pronounced in eyes without prior pegaptanib and/or PDT.

Intravitreal bevacizumab can lead to a rapid increase in vision that persists at 24 weeks. Naive eyes have a greater response than those previously treated with pegaptanib and/or photodynamic therapy.

From the *Department of Ophthalmology, North Shore–Long Island Jewish Health System, Great Neck, New York; †Long Island Vitreoretinal Consultants, Great Neck, New York; and ‡School of Management, New York Institute of Technology, Old Westbury, New York.

None of the authors has any proprietary interest in the subject matter.

Reprint requests: Vincent A. Deramo, MD, Long Island Vitreoretinal Consultants, 600 Northern Blvd., Suite 216, Great Neck, NY 11021.

© The Ophthalmic Communications Society, Inc.