Intravitreal Bevacizumab for Treatment of Neovascular Age-related Macular Degeneration: A One-year Prospective Study

Bashshur, Ziad F.; Haddad, Zeina; Schakal, Alexandre; Jaafar, Rola; Saab, Marc; Noureddin, Baha’ N.

doi:10.1016/j.ajo.2007.09.031

Cited by 186 publications

(127 citation statements)

References 30 publications

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“…Easy access and relatively low cost have caused it to be widely used for the treatment of neovascular eye diseases. Bevacizumab seems to have yielded similar results, when compared to ranibizumab, regarding visual stabilization and recovery in neovascular AMD, but its use is still considered off-label (9)(10)(11) .…”

Section: Introductionmentioning

confidence: 80%

Intravitreal bevacizumab in pigmented rabbit eyes: histological analysis 90 days after injection

Arraes¹,

Tedesco²,

Arraes³

et al. 2009

Arq. Bras. Oftalmol.

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Section: Introductionmentioning

confidence: 80%

Intravitreal bevacizumab in pigmented rabbit eyes: histological analysis 90 days after injection

Arraes¹,

Tedesco²,

Arraes³

et al. 2009

Arq. Bras. Oftalmol.

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“…The observed increase in VA is also closely similar to the increase of 10.8 ETDRS letters after ranibizumab three times and additional injections when necessary based on OCT and VA change [21]. It is interesting to see that in the 1-year follow-up study of Bashur et al, fewer injections were needed than in the 1-year follow-up study on ranibizumab of Fung et al, with almost the same criteria for reinjection, knowing that the intravenous half-life of bevacizumab is 150% that of ranibizumab in rabbit eyes [5,6,8,21]. However, the dosage in Bashur's study was 2.5 mg bevacizumab.…”

Section: Discussionmentioning

confidence: 99%

A systematic review on the effect of bevacizumab in exudative age-related macular degeneration

Schouten

Heij

Webers

et al. 2008

Graefes Arch Clin Exp Ophthalmol

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Aim To provide evidence for the effect of bevacizumab on visual acuity (VA) and central retinal thickness (CRT) in exudative age-related macular degeneration Methods A systematic review of all articles of bevacizumab for exudative AMD was conducted. Articles published up to March 2008 were identified in Medline, Embase, the Cochrane Controlled Trials Register and references from included articles. Search terms were "Bevacizumab or Avastin" and "Macula* or ARMD or AMD or intra(-) vitreal or intra(-)vitreous". Three observers participated in the data retrieval and assignment of the quality scores. Results A total of 561 articles were retrieved. Three randomised controlled trials (RCT) and 23 before-and-after studies of patients (n=1,435) who had received bevacizumab were published. Inclusion criteria varied. Lack of masking was the main methodological shortcoming. These RCTs showed that bevacizumab is more effective than PDT. Bevacizumab was given intravenously or as intravitreal injection. The latter was given once, or repeatedly every 4 weeks, and with or without additional injection when a recurrence occurred, mostly based on visual acuity and/or findings from optical coherence tomography. After intravenous administration, the weighted mean change in VA was +12.8 ETDRS letters (range +11 to +14) and the weighted mean change for CRT was −129 μm (range −100 to −202). For the 23 studies with intravitreal injections, the change in VA was +8.6 letters (range +2 to +26) and the change in CRT was −90 μm (range −46 to −190). The incidence of adverse events was low. The change in VA was 2.7 letters higher for studies with a higher quality vs lower quality. Conclusion Visual acuity improves and central retinal thickness decreases in patients with exudative AMD after bevacizumab. There is no reasonable doubt that this is caused by bevacizumab. It is likely that a randomised controlled trial will show that bevacizumab is equivalent in effect to ranibizumab, which showed a change in ETDRS of +5.9 letters for occult or minimally classic CNV and +9.8 letters for classic CNV after three monthly injections in two large RCTs.

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“…18,19 In addition, the effectiveness of intravitreously injected VEGF inhibitors has been analysed in clinical studies. [20][21][22][23] However, the results of all the different therapeutic procedures have not been compared up to now. Therefore, the aim of this study was to evaluate the data of 328 patients suffering from exudative AMD with serous PED who received different treatment procedures.…”

Section: Introductionmentioning

confidence: 99%

Serous pigment epithelial detachment in age-related macular degeneration: comparison of different treatments

Lommatzsch

Heimes

Gutfleisch

et al. 2009

Eye

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Aims To investigate the therapeutic effects of different treatments on serous pigment epithelium detachment (PED) in age-related macular degeneration (AMD). Methods A total of 328 patients suffering from serous PED in AMD were retrospectively analysed. We treated only patients with documented visual deterioration: 86 patients with bevacizumab, 128 with ranibizumab, 60 with pegaptanib, and 54 with photodynamic therapy (PDT) combined with intravitreal triamcinolone acetonide (IVTA). Bestcorrected vision was determined in the logarithm of the minimal angle of resolution (logMAR). We also analysed morphological findings such as full foveal thickness by optical coherence tomography (OCT), manually calculated height of PED as measured by OCT, and fluorescence angiography. Results The mean follow-up was 42.4 weeks. The best-corrected visual acuity of 0.78 logMAR before treatment could be improved by about 0.066 logMAR after treatment. Retinal thickness decreased in all patients with PED, in the mean by about 64.06 lm, and the mean value of the manually calculated height decreased by about 0.98 units. All functional and morphological results proved to be significantly better after injection of ranibizumab and bevacizumab than after pegaptanib and the combined treatment with PDT and IVTA. In all, 41 (12.5%) of our patients developed a tear of the retinal pigment epithelium (RPE). Conclusion The therapeutic results were significantly better in patients treated with bevacizumab and ranibizumab than in those treated with pegaptanib or with a combination of PDT and IVTA. Even with treatment, tears of the RPE or only a partial flattening of the PED always indicated a worse prognosis in eyes with exudative AMD than in eyes with classic choroidal neovascularization.

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Intravitreal Bevacizumab for Treatment of Neovascular Age-related Macular Degeneration: A One-year Prospective Study

Cited by 186 publications

References 30 publications

Intravitreal bevacizumab in pigmented rabbit eyes: histological analysis 90 days after injection

Intravitreal bevacizumab in pigmented rabbit eyes: histological analysis 90 days after injection

A systematic review on the effect of bevacizumab in exudative age-related macular degeneration

Serous pigment epithelial detachment in age-related macular degeneration: comparison of different treatments

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