The effect of intravitreal bevacizumab (Avastin®) on ocular pulse amplitude in neovascular age-related macular degeneration

Abstract

PurposeTo evaluate the effect of intravitreal (IVT) bevacizumab in neovascular age-related macular degeneration (AMD) on global choroidal hemodynamics, as measured by ocular pulse amplitude (OPA).MethodsThis was a two-center prospective study (Sheba Medical Center, Israel, and University Hospitals Leuven, Belgium). AMD patients who required IVT bevacizumab (1.25 mg/0.05 mL; first or repeated) were examined three times: at days 0 (prior to injection), 7 (±3), and 28 (±7) postinjection. At each visit, OPAs of both eyes were measured using the Pascal dynamic contour tonometer (DCT). A paired t-test between preoperative and postoperative OPA was conducted. Pearson correlation was used to evaluate the influence of various measured parameters on DCT–OPA.ResultsA total of 38 neovascular AMD patients were recruited, and 30 patients were included in the final analysis (18 females and 12 males; age 78.8 ± 5.82 years [mean ± standard deviation]). A good correlation was found throughout the study between the DCT–intraocular pressure (IOP) and Goldmann IOP and between DCT–IOP and DCT–OPA. No change in OPA of bevacizumab-treated eyes was found between the visits (2.24 ± 0.73, 2.2 ± 0.86, and 2.23 ± 0.73 mm Hg at visits 1, 2, and 3, respectively; paired t-test: P = 0.77 between visits 1 and 2, P = 0.98 between visits 1 and 3). No correlations were found between DCT–OPA and age, heart rate, systemic blood pressure, axial length, keratometry readings, and central corneal thickness.ConclusionsOPA, an indirect measure of global choroidal hemodynamics, remains unchanged following IVT off-label bevacizumab. This finding adds to the growing evidence regarding the safety profile of bevacizumab in AMD treatment.