Intravitreal bevacizumab (Avastin) for the treatment of choroidal neovascularization in age-related macular degeneration: results from 118 cases

Madhusudhana, K.C., Hannan, S.R., Williams, C.P.R., Goverdhan, S.V., Rennie, C., Lotery, A.J., Luff, A.J. and Newsom, R.S.B. (2007) Intravitreal bevacizumab (Avastin) for the treatment of choroidal neovascularization in age-related macular degeneration: results from 118 cases. British Journal of Ophthalmology, 91 (12), 1716-1717. (doi:10.1136/bjo.2006.108639).

Abstract

A retrospective review of 115 consecutive patients (118 eyes) based at Southampton Eye Unit, treated with intravitreal bevacizumab for CNV was performed. Lesions of all types irrespective of size or location that were either ineligible for photodynamic therapy (PDT) under the National Health Service (including minimally classic and occult CNV) or those not responding to PDT (classic or predominantly classic CNV with recurrent or persistent CNV activity) were included in the study (table 1). All patients underwent visual acuity testing (best corrected Snellen), slitlamp examination and fundus fluorescein angiography. Central macular thickness (CMT) was assessed using Stratus optical coherence tomography (Carl Zeiss Meditec, USA). After discussion about the off-label nature of treatment and the potential risks, informed consent was obtained from all patients. Intravitreal bevacizumab 1.25 mg was injected via the pars plana under sterile conditions; topical antibiotics were given for five days postoperatively. Patients were followed up at 2–4 weeks and then at 1-month intervals; Repeat injections were offered in the event of persistent lesion activity (indicated by persistent intraretinal/subretinal fluid or fibrovascular pigment epithelial detachment). All patients were monitored for any systemic and ocular adverse events. Blood pressure was measured before and 4–6 weeks after treatment.
Snellen visual acuity was converted to a standard logarithm of the minimum angle of resolution scale and ETDRS letter score for statistical analysis.6 The Mann–Whitney test was used to compare the mean visual acuity and CMT, before and after treatment.

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Contributors

Author: A.J. Lotery

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