Intravitreal bevacizumab (Avastin) treatment of neovascular age-related macular degeneration

M. Vaughn Emerson, Andreas (Andy) Lauer, Christina Flaxel, David Wilson, Peter J. Francis, J. Timothy Stout, Geoffrey G. Emerson, Thomas K. Schlesinger, Susan K. Nolte, Michael Klein

Research output: Contribution to journalArticle

129 Citations (Scopus)

Abstract

PURPOSE: To report the change in visual acuity and central retinal thickness by optical coherence tomography (OCT) after intravitreal injections of bevacizumab for the treatment of neovascular age-related macular degeneration (AMD). METHODS: A retrospective case series in a university-based practice evaluated patients with subfoveal choroidal neovascularization (CNV) due to AMD. Patients received intravitreal injections (1.25 mg) of bevacizumab and were monitored monthly with determination of best-corrected ETDRS visual acuity and OCT for persistence of retinal thickening. Eyes were retreated on an "as needed" basis, defined by presence of intraretinal or subretinal fluid. Patients were monitored every 2 months to 3 months for persistence of angiographic leakage. RESULTS: Seventy-nine eyes of 74 consecutive patients received the initial injection of bevacizumab between August 1, 2005, and January 30, 2006. Sixty-eight eyes (86%) of 64 patients had at least 3 months of follow-up. Mean central retinal thickness ± SD decreased from 304 ± 83 μm at baseline to 237 ± 105 μm at 3 months (P = 0.00002). Mean ETDRS visual acuity gained 4 letters from 20/100 at baseline to 20/80-1 at 3 months (P = 0.040). Twenty eyes (25%) appeared to have a sustained response to a single injection and did not require further injections through 3 months. Two patients had a potentially drug-related adverse event (ischemic stroke and myocardial infarction). No serious injection-related adverse events occurred. CONCLUSIONS: Intravitreal bevacizumab injection affects a rapid decrease in retinal thickness to normal or near-normal levels and improvement in visual acuity in eyes with CNV due to AMD. The sustainability of changes in retinal thickness and visual acuity in response to bevacizumab treatment warrant further investigation and long-term follow-up.

Original languageEnglish (US)
Pages (from-to)439-444
Number of pages6
JournalRetina
Volume27
Issue number4
DOIs
StatePublished - Apr 2007

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Macular Degeneration
Visual Acuity
Intravitreal Injections
Choroidal Neovascularization
Injections
Optical Coherence Tomography
Therapeutics
Subretinal Fluid
Drug-Related Side Effects and Adverse Reactions
Bevacizumab
Stroke
Myocardial Infarction

Keywords

  • Age-related macular degeneration
  • Bevacizumab
  • Choroidal neovascularization
  • Optical coherence tomography

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems

Cite this

Intravitreal bevacizumab (Avastin) treatment of neovascular age-related macular degeneration. / Emerson, M. Vaughn; Lauer, Andreas (Andy); Flaxel, Christina; Wilson, David; Francis, Peter J.; Stout, J. Timothy; Emerson, Geoffrey G.; Schlesinger, Thomas K.; Nolte, Susan K.; Klein, Michael.

In: Retina, Vol. 27, No. 4, 04.2007, p. 439-444.

Research output: Contribution to journalArticle

Emerson, M. Vaughn ; Lauer, Andreas (Andy) ; Flaxel, Christina ; Wilson, David ; Francis, Peter J. ; Stout, J. Timothy ; Emerson, Geoffrey G. ; Schlesinger, Thomas K. ; Nolte, Susan K. ; Klein, Michael. / Intravitreal bevacizumab (Avastin) treatment of neovascular age-related macular degeneration. In: Retina. 2007 ; Vol. 27, No. 4. pp. 439-444.
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AU - Lauer, Andreas (Andy)

AU - Flaxel, Christina

AU - Wilson, David

AU - Francis, Peter J.

AU - Stout, J. Timothy

AU - Emerson, Geoffrey G.

AU - Schlesinger, Thomas K.

AU - Nolte, Susan K.

AU - Klein, Michael

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N2 - PURPOSE: To report the change in visual acuity and central retinal thickness by optical coherence tomography (OCT) after intravitreal injections of bevacizumab for the treatment of neovascular age-related macular degeneration (AMD). METHODS: A retrospective case series in a university-based practice evaluated patients with subfoveal choroidal neovascularization (CNV) due to AMD. Patients received intravitreal injections (1.25 mg) of bevacizumab and were monitored monthly with determination of best-corrected ETDRS visual acuity and OCT for persistence of retinal thickening. Eyes were retreated on an "as needed" basis, defined by presence of intraretinal or subretinal fluid. Patients were monitored every 2 months to 3 months for persistence of angiographic leakage. RESULTS: Seventy-nine eyes of 74 consecutive patients received the initial injection of bevacizumab between August 1, 2005, and January 30, 2006. Sixty-eight eyes (86%) of 64 patients had at least 3 months of follow-up. Mean central retinal thickness ± SD decreased from 304 ± 83 μm at baseline to 237 ± 105 μm at 3 months (P = 0.00002). Mean ETDRS visual acuity gained 4 letters from 20/100 at baseline to 20/80-1 at 3 months (P = 0.040). Twenty eyes (25%) appeared to have a sustained response to a single injection and did not require further injections through 3 months. Two patients had a potentially drug-related adverse event (ischemic stroke and myocardial infarction). No serious injection-related adverse events occurred. CONCLUSIONS: Intravitreal bevacizumab injection affects a rapid decrease in retinal thickness to normal or near-normal levels and improvement in visual acuity in eyes with CNV due to AMD. The sustainability of changes in retinal thickness and visual acuity in response to bevacizumab treatment warrant further investigation and long-term follow-up.

AB - PURPOSE: To report the change in visual acuity and central retinal thickness by optical coherence tomography (OCT) after intravitreal injections of bevacizumab for the treatment of neovascular age-related macular degeneration (AMD). METHODS: A retrospective case series in a university-based practice evaluated patients with subfoveal choroidal neovascularization (CNV) due to AMD. Patients received intravitreal injections (1.25 mg) of bevacizumab and were monitored monthly with determination of best-corrected ETDRS visual acuity and OCT for persistence of retinal thickening. Eyes were retreated on an "as needed" basis, defined by presence of intraretinal or subretinal fluid. Patients were monitored every 2 months to 3 months for persistence of angiographic leakage. RESULTS: Seventy-nine eyes of 74 consecutive patients received the initial injection of bevacizumab between August 1, 2005, and January 30, 2006. Sixty-eight eyes (86%) of 64 patients had at least 3 months of follow-up. Mean central retinal thickness ± SD decreased from 304 ± 83 μm at baseline to 237 ± 105 μm at 3 months (P = 0.00002). Mean ETDRS visual acuity gained 4 letters from 20/100 at baseline to 20/80-1 at 3 months (P = 0.040). Twenty eyes (25%) appeared to have a sustained response to a single injection and did not require further injections through 3 months. Two patients had a potentially drug-related adverse event (ischemic stroke and myocardial infarction). No serious injection-related adverse events occurred. CONCLUSIONS: Intravitreal bevacizumab injection affects a rapid decrease in retinal thickness to normal or near-normal levels and improvement in visual acuity in eyes with CNV due to AMD. The sustainability of changes in retinal thickness and visual acuity in response to bevacizumab treatment warrant further investigation and long-term follow-up.

KW - Age-related macular degeneration

KW - Bevacizumab

KW - Choroidal neovascularization

KW - Optical coherence tomography

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