Abstract:
Purpose:
To study prospectively the safety and efficacy of intravitreal bevacizumab for eyes with neovascular age-related macular degeneration with baseline visual acuity better than 70 letters (Snellen equivalent better than 20/40).
Methods:
Patients with treatment-naive neovascular age-related macular degeneration were categorized prospectively into three groups according to baseline visual acuity: Group 1 (better than 70 letters), Group 2 (70 to 61 letters), and Group 3 (60 to 51 letters). Best-corrected visual acuity and central retinal thickness using optical coherence tomography were measured at baseline and at each follow-up visit. Intravitreal bevacizumab was administered according to an as-needed optical coherence tomography–guided regimen. Main outcome measure was mean best-corrected visual acuity for each group at 12 months.
Results:
Each group included 30 patients (30 eyes). Improvement in central retinal thickness was similar among the 3 groups (P = 0.964). Mean letter gain in visual acuity at 12 months was +0.4, +3.8, and +4.2 for Groups 1, 2, and 3, respectively (P = 0.42). Mean best-corrected visual acuity at 12 months was 78.4 letters for Group 1, 70.0 letters for Group 2, and 61.1 letters for Group 3 (P < 0.001). All eyes in Group 1 (100%) avoided losing 15 letters of best-corrected visual acuity versus 83.3% in Group 2 and 80.0% in Group 3. This difference was significant only between Group 1 and Group 3 (P = 0.02).
Conclusion:
Intravitreal bevacizumab for eyes with neovascular age-related macular degeneration and baseline visual acuity better than 70 letters was safe and able to maintain this vision over 12 months.
Eyes with neovascular age-related macular degeneration were categorized into three groups according to baseline visual acuity. Intravitreal bevacizumab was administered on an as-needed basis. By 12 months, the group with a mean baseline visual acuity of >70 letters achieved a better visual outcome than eyes with worse baseline visual acuity.
Citation:
El-Mollayess, G. M., Mahfoud, Z., Schakal, A. R., Salti, H. I., Jaafar, D., & Bashshur, Z. F. (2013). Intravitreal bevacizumab in the management of neovascular age-related macular degeneration: effect of baseline visual acuity. Retina, 33(9), 1828-1835.