Intravitreal bevacizumab in the management of neovascular age-related macular degeneration: effect of baseline visual acuity.

Abstract

PURPOSE:

To study prospectively the safety and efficacy of intravitreal bevacizumab for eyes with neovascular age-related macular degeneration with baseline visual acuity better than 70 letters (Snellen equivalent better than 20/40).

METHODS:

Patients with treatment-naive neovascular age-related macular degeneration were categorized prospectively into three groups according to baseline visual acuity: Group 1 (better than 70 letters), Group 2 (70 to 61 letters), and Group 3 (60 to 51 letters). Best-corrected visual acuity and central retinal thickness using optical coherence tomography were measured at baseline and at each follow-up visit. Intravitreal bevacizumab was administered according to an as-needed optical coherence tomography-guided regimen. Main outcome measure was mean best-corrected visual acuity for each group at 12 months.

RESULTS:

Each group included 30 patients (30 eyes). Improvement in central retinal thickness was similar among the 3 groups (P = 0.964). Mean letter gain in visual acuity at 12 months was +0.4, +3.8, and +4.2 for Groups 1, 2, and 3, respectively (P = 0.42). Mean best-corrected visual acuity at 12 months was 78.4 letters for Group 1, 70.0 letters for Group 2, and 61.1 letters for Group 3 (P < 0.001). All eyes in Group 1 (100%) avoided losing 15 letters of best-corrected visual acuity versus 83.3% in Group 2 and 80.0% in Group 3. This difference was significant only between Group 1 and Group 3 (P = 0.02).

CONCLUSION:

Intravitreal bevacizumab for eyes with neovascular age-related macular degeneration and baseline visual acuity better than 70 letters was safe and able to maintain this vision over 12 months.

• Authors: Georges M El-Mollayess, Ziyad Mahfoud, Alexandre R Schakal, Haytham I Salti, Dalida Jaafar, Ziad F Bashshur
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 33 Issue 9 Pg. 1828-35 (Oct 2013) ISSN: 1539-2864 [Electronic] United States
• PMID: 23615342 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Angiogenesis Inhibitors
• Antibodies, Monoclonal, Humanized
• VEGFA protein, human
• Vascular Endothelial Growth Factor A
• Bevacizumab

Topics

• Aged
• Angiogenesis Inhibitors (adverse effects, therapeutic use)
• Antibodies, Monoclonal, Humanized (adverse effects, therapeutic use)
• Bevacizumab
• Female
• Humans
• Intravitreal Injections
• Male
• Prospective Studies
• Tomography, Optical Coherence
• Treatment Outcome
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Visual Acuity (drug effects, physiology)
• Wet Macular Degeneration (diagnosis, drug therapy, physiopathology)