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STANDARDIZED VISUAL ACUITY RESULTS ASSOCIATED WITH PRIMARY VERSUS SECONDARY BEVACIZUMAB (AVASTIN) TREATMENT FOR CHOROIDAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION

2007; Lippincott Williams & Wilkins; Volume: 27; Issue: 6 Linguagem: Inglês

10.1097/iae.0b013e3180654240

1539-2864

Iryna Falkenstein, Lingyun Cheng, Victoria Morrison, Igor Kozak, Ajay M. Tammewar, William R. Freeman,

Retinal and Optic Conditions

In Brief Purpose: To compare standardized visual outcomes and macular thickness changes associated with primary and secondary bevacizumab (Avastin; Genentech, Inc., South San Francisco, CA) therapy for choroidal neovascularization (CNV) in age-related macular degeneration (AMD). Methods: Eighteen eyes received primary bevacizumab treatment; 20 eyes received pegaptanib (Macugen; Eyetech/OSI Pharmaceuticals, New York, NY) as initial treatment followed by bevacizumab therapy. Both medications were injected at 6-week intervals. Best-corrected visual acuity was measured with the ETDRS chart. Three- and 6-month data were analyzed for all eyes. Results: Mean visual acuity improvement in the primary bevacizumab treatment cohort was 1.5 ETDRS lines at 3 months (P = 0.0009) and 2.2 ETDRS lines at 6 months (P = 0.0004) compared with -0.4 ETDRS line at 3 months (P = 0.27) and 0.2 ETDRS line at 6 months (P = 0.70) in the secondary bevacizumab treatment group. Mean decrease in retinal thickness was also higher in the primary bevacizumab treatment group (90.9 μm [P = 0.0037] vs 43.8 μm [P = 0.13], respectively) than in the secondary bevacizumab treatment group (73.72 μm [P = 0.051] vs 33.0 μm [P = 0.21], respectively) at 3 months and 6 months. Conclusion: Primary bevacizumab therapy resulted in significantly greater visual improvement than secondary bevacizumab treatment at 3 months or 6 months. To our knowledge, this is the first report comparing primary bevacizumab treatment of CNV in AMD with secondary bevacizumab treatment after multiple pegaptanib injections. Intravitreal bevacizumab (Avastin) treatment resulted in significantly better visual outcomes (ETDRS lines) at 3 months and 6 months in patients who received bevacizumab as primary therapy for choroidal neovascularization than in patients who received it as salvage therapy after pegaptanib (Macugen) treatment.