Philippine Journal of Ophthalmology (Dec 2009)
Intravitreal bevacizumab for neovascular age-related macular degeneration
Abstract
Objectives: Anti-vascular endothelial growth factor (anti-VEGF) drugs delivered intravitreally have been proven effective and safe for the treatment of patients diagnosed with neovascular age-related macular degeneration (ARMD). This study evaluated the short-term biologic efficacy and safety of multiple intravitreal injections of bevacizumab in patients with neovascular ARMD. Methods: A prospective, interventional, placebo-controlled, randomized clinical trial was done involving patients with active subfoveal neovascular ARMD. Excluded were patients with significant media opacity, concomitant retinal/ocular diseases, previous intravitreal injections, recent laser treatment or intraocular surgery, and contraindications to the drug. Demographic data were taken and a complete ocular examination, fluorescein angiogram (FA), and optical coherence tomogram (OCT) were performed. Patients received either 3 monthly intravitreal injections of 1.25mg bevacizumab or sham injections. Best-corrected visual acuity (BCVA) and central macular thickness were recorded at baseline, 2, 4, 8, and 12 weeks follow-up. Ocular/Periocular or systemic drug-related side effects or toxicities and iatrogenic complications were noted. Results: Thirty eyes (15 per group) were included in the final analysis. Both treatment and control groups were comparable in baseline characteristics. There was a significant increase in the mean visual acuity (p < 0.001) in eyes treated with bevacizumab across all time periods. The average gain at the end of the study was 11.6 letters. This paralleled a similar significant decrease in central macular thickness for the treatment group (p < 0.02). No major ocular adverse events were noted. Conclusion: This study supported the growing body of evidence that intravitreal injections of bevacizumab 1.25 mg result in short-term anatomical as well as functional improvement with minimal adverse events in patients with neovascular ARMD.
