Intravitreal Bevacizumab for Choroidal Neovascularization Secondary to Age-Related Macular Degeneration-A Short-Term Study

Purpose: To evaluate the short-term safety and efficacy of intravitreal bevacizumab for managing neovascular age-related macular degeneration (AMD). Methods: A retrospective review was conducted on patients with neovascular AMD treated with 2.5 mg intravitreal bevacizumab. All patients were followed up at one week and then monthly with or without additional injections for at least three months. Best-corrected visual acuity (BCVA), dilated fundus examination and optical coherence tomography were performed at each visit. Fluorescein angiography (FAG) was also performed before and after treatment. Main outcome measures included change in BCVA and central retinal thickness (CRT). Results: Thirty-five eyes of 30 patients were included. The average number of injection was 1.72 times per eye. Seventeen eyes (49%) had at least one prior treatment. No significant differences were noted between eyes with and without prior treatment in BCVA or CRT change at all visits. The mean BCVA improved from 6/119 at baseline to 6/95 and 6/68 at one week and three months respectively. (all p≦0.005) Fourteen eyes of 33 eyes (42%) had improvement in visual acuity defined as a halving of visual angle at three months. The mean CRT reduced from 306 μm at baseline to 255 and 232 Jim at one week and three months visit (p=0.005 and p＜0.001 respectively). Those with thicker CRT have greater reduction. (r=-0.84 to -0.80, Pearson correlation, p＜0.001 for all visits). Two eyes (6%) had mild anterior chamber reaction. No increased intra-ocular pressure, retinal tear, vitreous hemorrhage or endophthalmitis was noted. Conclusions: Intravitreal bevacizumab is a promising treatment for patients with choroidal neovascularization (CNV) secondary to AMD as a primary or rescue management. Significant improvements were noted in both visual acuity and CRT. No obvious short-term safety concerns were noted. The long-term safety and efficacy of this treatment need further study.