Bevacizumab For Age-related Macular Degeneration Research Articles

Intravitreal bevacizumab for age-related macular degeneration with good visual acuity

To retrospectively study the efficacy of intravitreal bevacizumab (IVB) for exudative age-related macular degeneration (AMD) in patients with good visual acuity (VA). Fifteen eyes of 15 patients (mean age, 69.0 ± 11.3 years) with AMD whose VA was 0.6 or better were treated with IVB 1.25 mg/0.05 ml. The patients were followed for 12 to 29 months (mean, 17.4 ± 4.9 months). Best-corrected visual acuity (BCVA) ranged from 0.6 to 1.2 (mean, 0.89 ± 0.21) at baseline and was stable in 13 of 15 eyes (86.7%) when BCVA was 0.6 or better at the end of follow-up. The VA levels did not differ significantly (P = 0.42; paired t test) between baseline and the final examination. Two of the 15 eyes underwent photodynamic therapy during follow-up. The mean central retinal thickness significantly decreased from 278.4 ± 71.9 μm at baseline to 240.00 ± 58.5 μm at 3 months after the first IVB treatment (P = 0.02; Wilcoxon signed rank test). During follow-up, a mean of two injections was administered, and 47% of patients required only one injection. No adverse events developed. IVB was effective for maintaining good vision in exudative AMD in 15 eyes for at least 12 months.

CFH, VEGF, and PEDF genotypes and the response to intravitreous injection of bevacizumab for the treatment of age-related macular degeneration.

We determined whether there is an association between complement factor H (CFH), high-temperature requirement A-1 (HTRA1), vascular endothelial growth factor (VEGF), and pigment epithelium-derived factor (PEDF) genotypes and the response to treatment with a single intravitreous injection of bevacizumab for age-related macular degeneration (AMD). Eighty-three patients with exudative AMD treated by bevacizumab injection were genotyped for three single nucleotide polymorphisms (SNPs; rs800292, rs1061170, rs1410996) in the CFH gene, a rs11200638-SNP in the HTRA1 gene, three SNPs (rs699947, rs1570360, rs2010963) in the VEGF gene, and four SNPs (rs12150053, rs12948385, rs9913583, rs1136287) in the PEDF gene using a TaqMan assay. The CT genotype (heterozygous) of CFH-rs1061170 was more frequently represented in nonresponders in vision than TT genotypes (nonrisk allele homozygous) at the time points of 1 and 3months, while there was no CC genotype (risk allele homozygous) in our study cohort (p = 7.66 × 10(-3), 7.83 × 10(-3), respectively). VEGF-rs699947 was also associated with vision changes at 1month and PEDF-rs1136287 at 3months (p = 5.11 × 10(-3), 2.05 × 10(-2), respectively). These variants may be utilized for genetic biomarkers to estimate visual outcomes in the response to intravitreal bevacizumab treatment for AMD.

Intravitreal bevacizumab (Avastin) for age-related macular degeneration: a critical analysis of literature

The current medical environment demands that quality health care is delivered at an affordable cost through the use of objective, unbiased clinical data. This study was undertaken to review the current literature on bevacizumab for age-related macular degeneration and its value in determining best clinical practice. Randomised controlled trials (RCTs) and observational studies that met the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria were identified from the current literature for further analysis. Data concerning treatment dosing regimens, response to treatment, complications, and factors influencing outcome and safety were extracted and compiled into a database. As of January 2009, there were 5 RCTs that compared the outcomes of bevacizumab to other treatment options and 50 studies that met the STROBE criteria with similar visual and anatomical outcomes between RCTs and observational studies. Although the doses and dosing frequencies varied between the studies, the mean gain in vision at 3 months was +7.76+/-5.4 ETDRS letters (range +2 to +14.4); an effect that was maintained at 6 months in studies with longer follow-up. Predominantly classic lesions were the most responsive of all lesion subtypes. The complication profiles/rates were similar to those reported with other anti-vascular endothelial agents. There is sufficient scientific and statistical evidence to advocate the effective use of OCT-guided administration of intravitreal bevacizumab for neovascular AMD. This is reflected in our study outcome measures that are comparable to findings published from recent well-conducted RCTs on intravitreal ranibizumab at the same time point.