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Our Two – Years Experience with the Bevacizumab (Avastin) Treatment of the Age Related Macular Degeneration Wet Form


Authors: J. Doležalová;  Karel. I.;  H. Hallová
Authors‘ workplace: Oční klinika JL – Nové Butovice, Praha, přednosta MUDr. Ján Lešták, CSc.
Published in: Čes. a slov. Oftal., 66, 2010, No. 1, p. 10-14

Overview

Aim:
To evaluate the results of the intravitreal Avastin injection treatment in patients with the wet form of the age related macular degeneration and to point out some problems of this treatment.

Material and methods:
The study group consisted of 71 eyes of 71 patients; the follow up period was 6–24 months, on average, 18.5 months. The first subgroup consisted of 31 eyes treated in the first year, the second subgroup 40 eyes treated in the second year of the study. At the beginning of the treatment, the visual acuity in the first subgroup was 0.05 – 0.8, on average 0.26, in the second subgroup 0.1–0.6, on average 0.3. Most frequently, the occult form of the subretinal neovascular membrane was diagnosed (60.6 %). Results: There were applied 1 – 6 injections, on average, 3.52 injections. The frequency of applications was set according to the PRONTO study schedule for Lucentis application. The neuroepithelium thickness decreased by more than 100 μm in 35.2 % of eyes, was stabilized in 46.5 % of eyes, and increased by more than 100 μm in 11.3 % of eyes. In the first subgroup, the visual acuity stabilized in 90.3 % of eyes, in the second one in 95 %, and in the whole group in 93 % of eyes. Improvement by more than 15 letters of the ETDRS chart was recorded in the whole group in 8 eyes (11.3 %) and, on the other hand, the worsening by more than 15 letters in 5 eyes (7 %). We recorded no systemic complications; in no eye we had to treat the endophthalmitis, nor the retinal detachment.

Conclusions:
Several times lower price, safety, and positive results of intravitreal Avastin injection treatment support its use in the competition with other anti-VEGF substances.

Key words:
age related macular degeneration, anti-VEGF, Avastin


Sources

1. Arevalo, J. F., Fromow-Guerra, J., Sanchez, J. G., et al.: Primary intravitreal bevacizumab for subfoveal choroidal neovascularization in age-related macular degeneration: Result of the Pan-American Collaborative Retina Study Group at 12 Months Follow-up. Retina, 28, 2008; 10: 1387–1394.

2. Augustin, A., Puls, S., Offermann, I.: Triple therapy for choroidal neovascularization due to age-related macular degeneration: Vertepofin PDT, Bevacizumb, and Dexamethasone. Retina, 27, 2007; 2: 133–140.

3. Brown, D.M., Kaiser, P. K., Michels M. et al, for the ANCHOR Study Group. Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med, 2006; 355: 14–26.

4. Chan, C. K., Meyer, C. H., Gross, J. G., Abraham, P., et al.: Retinal pigment epithelial tears after intravitreal bevacizumab injection for neovascular age-related macular degeneration . Retina, 27, 2007; 5: 541–551.

5. Chen, E., Kaiser, R. S., Vander, J. F.: Intravitreal bevacizumab for refractory pigment epithelial detachment with occult choroidal neovascularisation in age-related macular degeneration. Retina, 27, 2007; 4: 445–450.

6. Coscas, F., Coscas, G., Souied, E., et al.: Optical Coherence Tomography Identification of Occult Choroidal Neovascularisation in Age-related Macular Degeneration. Am J Ophthalmol, 2007; 144: 592–599.

7. Emerson, M. V., Lauer, A. K., Flaxel, C. J., et al.: Intravitreal bevacizumab (Avastin) treatment of neovascular age-related macular degeneration. Retina, 27, 2007; 4: 439–444.

8. Falkenstein, I. A., Cheng, L., Morrison, V. L., et al.: Standardized visual acuity results associated with primary versus secondary bevacuzimab ( Avastin ) treatment for choroidal neovascularization in age-related macular degeneration. Retina, 27, 2007; 6: 701–706.

9. Fintak, D. R., Shah, G. K., Blinder, K. J., et al.: Incidence of endophthalmitis related to intravitreal injection of bevacizumab and ranibizumab. Retina, 28, 2008; 10: 1395–1399.

10. Fung, A. E., Lalwani, G. A., Rosenfeld, P. J. et al.: An optical coherence tomography-guided, variable dosing regimen with intravitreal ranibizumab (Lucentis) for neovascular age-related macular degeneration. Am J Ophthalmol, 2007; 143: 566–583.

11. Geitzenauer, W., Michels, S., Prager, F., et al.: Comparison of 2.5 mg/kg and 5 mg/kg systemic bevacizumab in neovascular age-related macular degeneration: Twenty-Four Week Result of an Uncontrolled, Prospective Cohort Study. Retina, 28, 2008; 10: 1375–1386.

12. Goff, M. J., Johnson, R. N., McDonald, H. R., et al.: Intravitreal bevacizumb for previously treated choroidal neovascularisation from age-related macular degeneration. Retina, 27, 2007; 4: 432–438.

13. Gradoudas, E.S., Adamis, A. P., Cunningham, E. T. Jr. et al.: Pegaptanib for neovascular age-related macular degeneration. N Engl J Med, , 2004; 351: 2805–2816.

14. Heiduschka, P., Julien, S., Hofmeister, S., et al.: Bevacizumab (Avastin) does not harm retinal function after intravitreal injection as shown by electroretinography in adult mice. Retina, 28, 2008; 1: 46–55.

15. Kumar, K., Symons, R. C. A.: Do Alternative Treatments for CNV Have a Place in the Era of VEGF Inhibition? Retinal physician, January-February, 2009: 28–31.

16. Mason, J. O., White, M. F., Feist, R. M., et al.: Incidence of acute onset endophthalmitis following intravitreal bevacizumb (Avastin) injection. Retina, 28, 2008; 4: 564–567.

17. Moshfeghi, D., Blumenkranz, M. S.: Role of genetic factors and inflammation in age-related macular degeneration. Retina, 27, 2007; 3: 269–275.

18. Navea, A., Mataix, J., Desco, M. C., et al.: One-year follow-up of combined customized therapy. Photodynamic therapy and bevacizumab for exsudative age-related macular degeneration. Retina, 29, 2009; 1: 13–19.

19. Ronan, S., Yoganathan, P., Chien, F. Y., et al.: Retinal pigment epithelium tears after intravitreal injection of bevacizumab (Avastin) for neovascular age-related macular degeneration. Retina, 27, 2007; 5: 535–540.

20. Rosenfeld, P. J., Brown, D. M., Heier, J. S. et al, for the MARINA Study Group. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med, 2006; 355: 1–13.

21. Shah, C. P., Hsu, J., Garg, S. J., et al.: Retinal Pigment Epithelial Tear after Intravitreal Bevacizumab Injection. Am J Ophthalmol, 2006; 142: 1070–1072.

22. Shah, G, K., Sang, D. N., Hughes, M. S.: Vertepofin combination regimens in the treatment of neovascular age-related macular degeneration. Retina, 29, 2009; 2: 133–148.

23. Smith, B. T., Dhalla, M. S., Shah, G. K., et al.: Intravitreal injection of bevacizumab combined with verteporfin photodynamic therapy for choroidal neovascularization in age-related macular degeneration. Retina, 28, 2008; 5: 675–681.

24. Yoganathan, P., Deramo, V. A., Lai, J. C., et al.: Visual improvement following intravitreal bevacizumab (Avastin) in exsudative age-related macular degeneration. Retina, 26, 2006; 9: 994–998.

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Ophthalmology
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