Effect of intravitreal bevacizumab (Avastin®) in neovascular age-related macular degeneration using a treatment regimen based on optical coherence tomography: 6-and 12-month results

Purpose: To study the effect of intravitreal bevacizumab therapy on visual and anatomical outcomes in patients with neovascular age-related macular degeneration (AMD) within a follow-up period of 6 and 12 months. Methods: A retrospective analysis of 102 eyes of 102 consecutive patients with neovascular AMD evaluated repeated intravitreal bevacizumab (1 or 2.5 mg) injections. Retreatment was performed following an optical coherence tomography (OCT)-based regimen. Ophthalmic examination included best-corrected visual acuity (BCVA), dilated fundus examination and OCT imaging. Data were analysed at baseline, 6 months (24 weeks) and 12 months (48 weeks) after treatment initiation. Results: BCVA remained stable at 6 months (mean: 0.00 +/- 0.41 logMAR; p = 0.95) and 12 months (mean: +0.02 +/- 0.43 logMAR; loss of similar to 1 letter; p = 0.70) after the first treatment. OCT retinal thickness decreased by a mean of -37.8 +/- 101.6 mu m (p < 0.05) compared to baseline at month 6 and -38.6 +/- 93.3 mu m (p < 0.05) at month 12. A mean of 2.6 +/- 1.2 injections were needed to obtain absence of fluid by OCT, and the time to recurrence was 23 +/- 11 weeks thereafter. There was no difference in BCVA and OCT outcomes between treatment-naive eyes and eyes that had undergone prior treatment. Conclusion: The 6- and 12-month follow-up of repeated intravitreal bevacizumab therapy in eyes with neovascular AMD demonstrated stabilization of vision and no safety concerns. An OCT-based retreatment strategy appears appropriate in the management of patients treated with intravitreal bevacizumab.