http://www.evrs.eu/medias/2006/congress/Intravitreal-Bevacizumab-(Avastin)-for-Primary-Treatment-of-Neovascular-AMD.swf

David F. Williams, MD, MBA (Minneapolis, MN), Steven R. Bennett, MD (Minneapolis, MN), Herbert L. Cantrill, MD (Minneapolis, MN), Jill B. Johnson, MD (Minneapolis, MN), Robert A. Mittra, MD (Minneapolis, MN), Robert C. Ramsay, MD (Minneapolis, MN), Edwin H. Ryan, MD (Minneapolis, MN), Sundeep Dev, MD (Minneapolis, MN)

PURPOSE:

To review short-term experience of intravitreal bevacizumab (Avastin) for primary treatment of choroidal neovascularization secondary to AMD.

METHODS:

The records of all patients undergoing primary therapy with intravitreal bevacizumab (Avastin) (1.25mg/0.05 ml) for newly diagnosed neovascular AMD between September 2005 and February 2006 were retrospectively reviewed. Data recorded included patient demographics, lesion characteristics, initial and follow-up visual acuity (VA), number and dates of intravitreal injections, follow-up duration, lesion response to therapy, and complications.

RESULTS:

There were 117 treated eyes in 115 patients, 36 male and 79 female. Lesion composition: Classic -15, minimally classic-13, occult-62, fibrovascular PED-22, serous PED-5. Number of injections: 1-53 eyes, 2-43 eyes, 3-17 eyes, 4-4 eyes. Duration between injections: 4-8 weeks. Follow-up: 6 to 24 weeks. At last follow-up 56% of eyes (66/117) were within one Snellen line of the pre-treatment VA, 38% (44/117) improved 2 lines or more, 6% (7/117) decreased 2 lines or more. 94% (110/117) of eyes had stable or improved visual acuity. 62% (73/117) were judged to have improved appearance on fluorescein angiography and/or OCT. There were no serious injection related ocular complications. No patient developed hypertension, myocardial infarction or stroke. Four eyes (18%) with a fibrovascular PED and 1 eye (20%) with a serous PED developed an RPE rip following treatment; VA remained stable or improved in each eye. Ongoing follow-up continues on these eyes and will bereported.

CONCLUSION:

Primary treatment of neovascular AMD with intravitreal bevacizumab (Avastin) appears to provide at least a short-term beneficial effect with no serious ocular or systemic complications. Further investigation of this therapy is warranted.