Intravitreal Bevacizumab (Avastin) Treatment of Neovascular Age-Related Macular Degeneration

Emerson, Maxwell; Lauer, Andreas K.; Flaxel, Christina J.; Wilson, David J.; Francis, Peter J.; Stout, J. Timothy; Emerson, Geoffrey G.; Schlesinger, Thomas K.; Nolte, Susan K.; Klein, Michael L.

doi:10.1097/iae.0b013e31804b3e15

Cited by 155 publications

(106 citation statements)

References 13 publications

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“…[40][41][42] In particular, recent studies have shown that repeated monotherapy with anti-VEGF ranibizumab or bevacizumab may improve vision in patients with CNV of all types. [43][44][45] Sakaguchi et al 46 performed intravitreal bevacizumab (1 mg) injection to treat eight eyes with myopic CNV and improvement of BCVA to two or more lines was found in six eyes (75%). In our study, myopic CNV responded markedly better to PDT/PSTA than other types of CNV, and 64.7% of eyes in this subgroup had improvement of BCVA to more than two lines.…”

Section: Discussionmentioning

confidence: 99%

Photodynamic therapy combined with posterior subtenon triamcinolone acetonide injection in the treatment of choroidal neovascularization

et al. 2008

Eye

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Purpose To evaluate the therapeutic effect of photodynamic therapy (PDT) combined with posterior subtenon injection of triamcinolone acetonide (PSTA) in the treatment of choroidal neovascularization (CNV). Methods In this retrospective case-control study, treatment outcomes at 12 months of patients with CNV were reviewed. One hundred and two consecutive patients (102 eyes) with subfoveal CNV of various causes were included. Patients in the study group (n ¼ 46) received PDT followed within 2 days by 40 mg of PSTA. Patients in the control group (n ¼ 56) received PDT alone. Patients were retreated 3 months later or more if fluorescein angiography showed residual membrane leakage. Treatment outcomes were compared between the two groups and among different CNV subgroups. Results Gain in mean best-corrected visual acuity (BCVA) was significantly higher in the study group ( þ 0.78 lines) than in the control group (À1.86 lines) (Po0.0001). The number of treatments within 1 year was significantly less in the study group (1.26 vs 1.63, P ¼ 0.008). The mean BCVA change for myopic CNV and age-related predominantly classic CNV subgroups was significantly higher in the study group ( þ 2.82 vs À0.91 lines, P ¼ 0.0005 for myopic CNV; þ 0.6 vs À1.79 lines, P ¼ 0.01 for age-related predominantly classic CNV). The main side effect in the study group was increased intraocular pressure (8.7%). ConclusionCompared with PDT alone, PDT combined with PSTA has a better therapeutic effect for both myopic and age-related predominantly classic CNV; the myopic CNV subgroup shows the best response.

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Section: Discussionmentioning

confidence: 99%

Photodynamic therapy combined with posterior subtenon triamcinolone acetonide injection in the treatment of choroidal neovascularization

et al. 2008

Eye

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“…4 On the other hand, intraocular injection of low-dose bevacizumab is considered as a safe and effective treatment for neovascular age-related macular degeneration. 5,6 Observational studies have reported no significant short-term side effects and few long-term cardiovascular side effects. 6e8 To our knowledge, there have been no reports of acute cardiac complications with bevacizumab treatment.…”

Section: Discussionmentioning

confidence: 99%

Reversible myocardial dysfunction following intraocular bevacizumab administration

Penumetsa

Hoque

Giugliano

2013

Journal of Cardiovascular Disease Research

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a b s t r a c tHeart failure has been reported as a rare side effect of bevacizumab, a chemotherapeutic agent, used in the treatment of breast cancer. However, reversible left ventricular systolic dysfunction with a pattern similar to stress-induced cardiomyopathy has not been reported. The etiopathogenesis of stress-induced cardiomyopathy is poorly understood. Given this uncertainty, we should always look out for other potential offenders causing similar presentation, rather than label all of them as "stress-induced".

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“…20 There have also been reports of the full-length, monoclonal anti-VEGF antibody bevacizumab (Avastin s ; Genentech), which is approved for certain solid tumours (ie, metastatic colorectal cancer, non-small-cell lung cancer, breast cancer), administered as intravitreal injection in patients with neovascular AMD. [21][22][23][24][25][26][27][28] Findings from these small-scale, short-term, noncontrolled, non-randomized studies or case series have shown improvements in visual acuity of 3.1-7.4 letters from baseline over 1-12 months follow-up, as well as anatomical benefits, following bevacizumab. [21][22][23][24][25] Although bevacizumab was generally well tolerated, adverse events included endophthalmitis, retinal pigment epithelial tears, and submacular haemorrhage.…”

Section: Discussionmentioning

confidence: 99%

“…[21][22][23][24][25][26][27][28] Findings from these small-scale, short-term, noncontrolled, non-randomized studies or case series have shown improvements in visual acuity of 3.1-7.4 letters from baseline over 1-12 months follow-up, as well as anatomical benefits, following bevacizumab. [21][22][23][24][25] Although bevacizumab was generally well tolerated, adverse events included endophthalmitis, retinal pigment epithelial tears, and submacular haemorrhage. 21,26,28 The long-term efficacy and safety of bevacizumab in neovascular AMD have yet to be elucidated in large-scale, randomized, controlled trials.…”

Section: Discussionmentioning

confidence: 99%

Verteporfin therapy in occult with no classic CNV due to AMD: results of the Photodynamic Therapy in Occult-Only Lesions study

Soubrane

Harding

Wolf

et al. 2008

Eye

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Therapy in Occult-Only Lesions (POOL) Study Group AbstractPurpose To provide further information on verteporfin photodynamic therapy in occult with no classic choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). Methods Verteporfin therapy was administered at baseline and then at months 3, 6, and 9, if fluorescein leakage from CNV was evident on angiography. Results Of 202 patients enrolled, 184 completed 12 months. Each patient was treated in one eye only. All study eyes received verteporfin therapy at baseline, with a progressive decrease in the number treated at subsequent visits (mean 2.5 treatments during 12 months). The mean change in visual acuity letter score from baseline to month 12 was À11.9. At month 12, 164 eyes (82.4%) had lost o30 letters of visual acuity, 123 eyes (61.8%) had lost o15 letters, 78 eyes (39.2%) had lost o5 letters, 31 (15.6%) had 45-letter increase, and 7 (3.5%) had 415-letter improvement. The percentage of eyes with fluorescein leakage from CNV decreased from 75.5% at month 3 to 25.1% at month 12. Adverse events were documented for 54% patients. Few patients had treatment-associated adverse events (7%). Acute severe visual acuity decrease occurred in two eyes (1%), one of which had visual acuity that returned to baseline by the next follow-up visit.Conclusions This study provides additional evidence that over 12 months, verteporfin is generally well tolerated and maintains or improves visual acuity in over one-third of eyes containing occult-only CNV. Verteporfin also improved anatomical outcomes by reducing leakage from CNV in at least two-thirds of eyes.

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Intravitreal Bevacizumab (Avastin) Treatment of Neovascular Age-Related Macular Degeneration

Cited by 155 publications

References 13 publications

Photodynamic therapy combined with posterior subtenon triamcinolone acetonide injection in the treatment of choroidal neovascularization

Photodynamic therapy combined with posterior subtenon triamcinolone acetonide injection in the treatment of choroidal neovascularization

Reversible myocardial dysfunction following intraocular bevacizumab administration

Verteporfin therapy in occult with no classic CNV due to AMD: results of the Photodynamic Therapy in Occult-Only Lesions study

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