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Combination brachytherapy and anti-VEGF therapy demonstrates long-term safety and efficacy

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NEW YORK — The use of epimacular brachytherapy combined with bevacizumab appears safe for treatment of neovascular age-related macular degeneration and reduces the dosing burden of anti-VEGF therapy.

Pravin U. Dugel

After 2 years of follow-up in 34 patients treated with strontium 90 and Avastin (bevacizumab, Genentech) in a phase 2 study, 80% of patients who had cataract surgery before the study maintained vision and 30% gained significant vision. When compared with patients who had their natural lens, 65% of patients maintained vision and 20% gained significant vision.

Overall, patients received a mean 2.4 injections, including loading doses, and 76% of patients required no additional doses beyond the two required injections of bevacizumab, Pravin U. Dugel, MD, said here at the Retina Congress 2009.

Dr. Dugel said, "when this data is sub-analyzed by lens status, the compounding effect of cataract can be seen."

Patients undergoing brachytherapy had a 50% higher rate of cataract development, although that was partly expected due to the need for vitrectomy prior to brachytherapy, Dr. Dugel said.