Intravitreal Bevacizumab for the Management of Choroidal Neovascularization in Age-related Macular Degeneration

Bashshur, Ziad F.; Bazarbachi, Ali; Schakal, Alexandre; Haddad, Zeina; Haibi, Christelle P El; Noureddin, Baha’ N.

doi:10.1016/j.ajo.2006.02.037

Cited by 286 publications

(195 citation statements)

References 25 publications

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“…[4][5][6][7][8][9][10] The ratio of treating CNV with anti-vascular endothelial growth factor (anti-VEGF) is hindering angiogenesis factor being produced by retinal pigment epithelium (RPE) and retinal photoreceptors, and hence avoiding initiating and supporting the growth of abnormal CNV. 11,12 The use of indocyanine green angiography (ICGA) in diagnosing CSCR patients has improved our understanding in the pathogenesis of CSCR.…”

Section: Introductionmentioning

confidence: 99%

Intravitreal anti-vascular endothelial growth factor combined with half-fluence photodynamic therapy for choroidal neovascularization in chronic central serous chorioretinopathy

Smretschnig

Hagen

Glittenberg

et al. 2016

Eye

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Purpose To evaluate the results of indocyanine green angiography (ICGA)-guided verteporfin photodynamic therapy (PDT) with half-fluence rate combined with intravitreal application of anti-VEGF in treating choroidal neovascularization (CNV) in chronic central serous chorioretinopathy (CSCR). Patients and methods In this retrospective cohort study 17 consecutive patients with secondary CNV due to chronic CSCR had their diagnosis verified with fluorescein angiography (FA) and ICGA at baseline. All eyes received either intravitreal ranibizumab (IVR) or bevacizumab (IVB). On the consecutive day following the initial IVR/IVB treatment, ICGAguided verteporfin (6 mg/m 2 ) PDT with halffluence rate (25 J/cm 2 ) was performed on every patient. IVR or IVB was rescheduled on a pro re nata regimen. Main outcome measures were changes in visual acuity (VA) according to the ETDRS letter score and changes in the central foveal thickness (CFT). Results Best-corrected VA at baseline was 65.6 letters (±6.7; n = 17) according to the ETDRS letter score. At 12 months, mean ETDRS letter score improved to 71.2 letters (P = 0.34). CFT was 309 μm and decreased to 216 μm at month 12 control (P = 0.0004). Nine eyes (52.9%) received additional treatment with IVR/IVB due to recurrence of subretinal fluid, with an overall mean number of IVR/IVB treatment of 1.8 ± 3.6 per patient with no systemic side effects during 12 months' follow-up. Conclusions IVR or IVB combined with ICGA-guided half-fluence PDT with verteporfin is effective in treating CNV in chronic CSCR, with choroidal hyperpermeability in ICGA, resulting in stable vision and significant reduction of CFT.

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Section: Introductionmentioning

confidence: 99%

Intravitreal anti-vascular endothelial growth factor combined with half-fluence photodynamic therapy for choroidal neovascularization in chronic central serous chorioretinopathy

Smretschnig

Hagen

Glittenberg

et al. 2016

Eye

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“…Most recently, anti-VEGF therapy seems to be the most promising with bevacizumab showing significant efficacy to cause regression of the CNV. 2,3 Indications for treatment, retreatment, and/or surveillance have depended mainly upon the evaluation of CNV leakage and have used visual acuity as the outcome determinant.…”

Section: Introductionmentioning

confidence: 99%

Relationships between clinical measures of visual function and anatomic changes associated with bevacizumab treatment for choroidal neovascularization in age-related macular degeneration

Ünver

Yavuz

Bekiroğlu

et al. 2008

Eye

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Purpose This pilot study was undertaken to examine the relationships between clinical measures of visual function and anatomic changes occurring in the eyes treated with bevacizumab for choroidal neovascularization (CNV) due to age-related macular degeneration (AMD). Methods A retrospective review was conducted for 50 eyes that had been treated with at least three injections of bevicizumab for CNV due to AMD, and followed for at least 6 months. Vision outcomes included best-corrected ETDRS chart acuity, scored by best-line read (ETDRS line) and by total letters read (ETDRS letter), and two measures obtained from central acuity perimetry with 98% Michelson contrast targets, the best acuity within 61 of fixation (BA61), and global macular acuity (GMA), representing a weighted average of the acuities thresholded at all intercepts within a 101 radius of fixation. Assessment of anatomic outcomes included fibrosis, atrophy, and subretinal hemorrhage grading on fundus photography, CNV size, pigment epithelial detachment (PED) size and grading of CNV leakage on fluorescein angiography, and central retinal PED, and subretinal fluid (SRF) thickness on optical coherence tomography. Results Logistic regression analysis showed an association between the vision outcomes of EDTRS letter and BA61 with the change in SRF thickness (R 2 : 0.47 and 0.35, respectively). The outcome of the vision measurement of GMA was associated with the change in SRF thickness, in CNV thickness, and in CNV fibrosis grade (R 2 : 0.34). No association was noted between the outcomes of ETDRS line with the change in any anatomic outcomes. Conclusion Acuity perimetry outcomes in this study seemed to offer improved understanding of the relationship between the vision outcomes and the measured anatomic changes. It seemed that neither ocular coherence tomography nor fluorescein angiography alone offered sufficient morphologic markers for prediction of functional outcomes.

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“…Even though originally approved by the Food and Drug Administration for the therapy of metastatic colorectal cancer, intravitreal bevacizumab administration has gained popularity in the therapy of neovascular AMD. [8][9][10][11] The long-term safety and efficacy of intravitreal bevacizumab application in neovascular AMD has not been assessed in randomized controlled clinical trials; there is even a need for a clinician and for a selection of suitable patients.…”

Section: Introductionmentioning

confidence: 99%

Retinal pigment epithelial tears after single administration of intravitreal bevacizumab for neovascular age-related macular degeneration

Gelişken¹,

Ziemssen²,

Voelker³

et al. 2008

Eye

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Purpose To analyse retinal pigment epithelial (RPE) tears following single administration of intravitreal bevacizumab for neovascular agerelated macular degeneration (AMD) during early follow-up. Methods Interventional, retrospective, noncomparative case series included 397 patients (409 eyes) of the 746 consecutive patients that met the eligibility criteria. Standardized visual acuity testing, fluorescein angiography, and optical coherence tomography were performed. Data collected included status of the fellow eye, previous treatment, subtypes of choroidal neovascularization (CNV), size and composition of the lesion. Multiple linear regression modelling was used to explore the effect of baseline parameters on the RPE tears. Primary end point was occurrence of RPE tears within 6 weeks after therapy. Results Fifteen of the 409 eyes (3.6%) developed RPE tear (95% confidence interval: 2.2-6.0, odds ratio: 26.3). The statistical modelling showed significant association between RPE tear and occult without classic CNV/predominantly haemorrhage vs predominantly/minimal classic CNV (P ¼ 0.019), as well as medium or large (44 disc area) vs small size of the total lesion (P ¼ 0.038). Previous treatment and status of the fellow eye did not statistically influence the risk of RPE tears. Conclusions An RPE tear can develop in up to 3.6% of eyes with neovascular AMD following single administration of intravitreal bevacizumab in a short-term follow-up. Medium and large lesion size and occult without classic and predominantly haemorrhagic subtype of CNV were important predictive factors. Preoperative assessment of the lesion characteristics may help in identifying the risk of individual patients with neovascular AMD before intravitreal bevacizumab treatment.

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Intravitreal Bevacizumab for the Management of Choroidal Neovascularization in Age-related Macular Degeneration

Cited by 286 publications

References 25 publications

Intravitreal anti-vascular endothelial growth factor combined with half-fluence photodynamic therapy for choroidal neovascularization in chronic central serous chorioretinopathy

Intravitreal anti-vascular endothelial growth factor combined with half-fluence photodynamic therapy for choroidal neovascularization in chronic central serous chorioretinopathy

Relationships between clinical measures of visual function and anatomic changes associated with bevacizumab treatment for choroidal neovascularization in age-related macular degeneration

Retinal pigment epithelial tears after single administration of intravitreal bevacizumab for neovascular age-related macular degeneration

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