Intravitreal bevacizumab for pigment epithelial detachments in age-related macular degeneration

To evaluate the efficacy and safety of intravitreal bevacizumab injections in patients with pigment epithelial detachments (PEDs) secondary to age-related macular degeneration (AMD).

In a retrospective interventional case series, 62 eyes of 61 patients were treated with 1.5 mg bevacizumab intravitreally. Baseline and follow-up visits included best-corrected visual acuity and optical coherence tomography (OCT) examinations. Follow-up visits were performed 1, 3, and 6 months after initial treatment. Morphological effects on PED were quantified by repetitively measuring the highest elevation on two perpendicular OCT cross-sections. If height of PED was increased by 50 microns, or intraretinal fluid appeared or increased, or visual acuity decreased more than 5 letters on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart, patients were reinjected.

On OCT, PED decreased from 346 ± 148 µm at baseline to 241 ± 159 µm (p < 0.001) at 1 month, 227 ± 193 µm (p < 0.001) at 3 months, and 166 ± 170 µm (p < 0.001) at 6 months. Mean best corrected visual acuity (BCVA) increased from 49 ± 18 letters at baseline to 52 ± 21 letters (p = 0.062) at 1 month. However, 3 and 6 months after initial injection mean BCVA returned to baseline levels (3 months: 49 ± 19 letters, p = 0.518; 6 months: 49 ± 20 letters, p = 0.053). On average, patients received 2.5 injections during the observation period of 6 months. Except for one retinal pigment epithelial (RPE) tear no other ocular or systemic adverse events were noticed. Ocular inflammation was not found in any of the investigated patients.

The presented data demonstrate a therapeutic effect of intravitreal bevacizumab in patients with specific classes of pigment epithelial detachments secondary to AMD.