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Intravitreal bevacizumab (Avastin®) in wet AMD: the OCT‐assisted “wait and see” management
Author(s) -
NERI P,
HERBORT CP
Publication year - 2008
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2008.6314.x
Subject(s) - medicine , bevacizumab , ophthalmology , surgery , chemotherapy
Purpose To retrospectively review the evolution of our patients managed with the OCT‐assisted “wait and see” approach after intravitreal bevacizumab (IB) injection. Methods Charts of 46 consecutive patients affected by wet AMD that had received IB (1.25 mg) for recent CNV and completed ≥ 9‐month follow‐up were reviewed. The patients were divided into 3 groups, on the basis of the number of injections: “1 injection” (group 1), “2 injections” (group 2) and “≥ 3 injections” (group 3). Visual gain and loss were defined as improvement or worsening of 2 or more lines of BCVA, respectively. Injections were repeated in case of OCT worsening and decreased BCVA, confirmed by FA. Main outcome measures were the stability/improvement of the BCVA, and both the FA and OCT stability/improvement. Results Sixteen patients needed only 1 injection (34.8%), 11 needed 2 injections (23.9%) and 16 (41.3%) patients ≥ 3 injections. In group 1, the median follow‐up time, was 14 months, while, in group 2 and 3, it was 12 months. In group 1, 14/16 patients (87.5%) had stable/improved BCVA (P<.05), while in group 2 and 3, 9/11 (81.8%, P<.05) and 17/19 (89.5%, P<.05) patients had stable/improved BCVA, respectively. All the patients that had stable/improved BCVA had both stable/improved FA and OCT. No differences were observed between the outcomes of the groups (P>.05). Conclusion In 1 patient out of 3 a single IB and in more than 50% of patients no more than 2 IB were sufficient to treat CNVs. Our data indicate that bevacizumab is effective even if administered on the basis of the CNV activity, and the scheme of 3 automatic initial injections proposed in trials using other anti‐VEGF agents should be revised at least for bevacizumab. Further trials are mandatory to validate our data.