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Intravitreal bevacizumab (avastin) for subfoveal neovascular age-related macular degeneration

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Abstract

Objective To report the visual and anatomic outcome of intravitreal bevacizumab (Avastin) injections in the treatment of subfoveal neovascular age-related macular degeneration (AMD). Methods Interventional, consecutive, retrospective case series. Sixty-five eyes of 65 patients with subfoveal neovascular age-related macular degeneration (AMD) received three intravitreal bevacizumab (1.25 mg) injections. Outcome measures included visual acuity (VA), central retinal thickness (CRT), and size of lesion at 24 or more weeks follow-up. Results Thirty-five eyes had prior treatment with photodynamic therapy (PDT). At presentation, VA was 1.12 ± 0.62 logMAR, CRT was 305 ± 115 μm, and greatest linear diameter (GLD) of the lesion was 4,902 ± 1,861 μm. There was no statistically significant difference between previous PDT and naïve eyes in VA, CRT, and GLD at presentation. After three bevacizumab injections, VA, CRT, and GLD significantly improved (P < 0.0001 in all groups). There was no statistically significant difference between CRT and GLD outcomes and subfoveal neovascular membrane type or age. Eyes with better VA at baseline and without previous PDT treatment achieved better final VA (P < 0.0001 and P = 0.045, respectively). A classic membrane type and lower age were somewhat associated with better post-treatment VA. Conclusions Short-term results suggest that intravitreal bevacizumab is well tolerated and associated with improvement in VA, decreased CRT, and decreased lesion size in most patients. The most important predictors of final VA outcomes were baseline VA and no previous PDT treatment. Further evaluation of intravitreal bevacizumab for the treatment of subfoveal neovascular AMD is warranted.

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Acknowledgments

The authors have no proprietary interest in any of the materials or techniques used in this study.

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Authors and Affiliations

  1. Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, P.O. Box 151, Beer-Sheva, 84101, Israel

    Jaime Levy, Marina Shneck, Itamar Klemperer, Orly Weinstein, Anry Pitchkhadze, Nadav Belfair & Tova Lifshitz

  2. The Center for Multidisciplinary Research in Aging, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Shirley Rosen

  3. University of Miami Miller School of Medicine, Miami, FL, USA

    David Rand

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  1. Jaime Levy
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  2. Marina Shneck
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Correspondence to Jaime Levy.

Additional information

This work was presented at 9th Michaelson Symposium on Ocular Circulation and Neovascularization, Baltimore, MD, USA, May 1–4, 2007.

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Levy, J., Shneck, M., Rosen, S. et al. Intravitreal bevacizumab (avastin) for subfoveal neovascular age-related macular degeneration. Int Ophthalmol 29, 349–357 (2009). https://doi.org/10.1007/s10792-008-9243-1

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