Study examines brachytherapy, anti-VEGF for neovascularization secondary to AMD

Br J Ophthalmol. 2009;93(3);305-309.

The concomitant delivery of epiretinal brachytherapy and bevacizumab for subfoveal choroidal neovascularization secondary to age-related macular degeneration appears safe and efficacious at 1 year, although a phase 3 trial will continue to monitor patients for an additional 2 years.

In the prospective, nonrandomized, multicenter trial, 34 patients with predominantly classic, minimally classic and occult subfoveal choroidal neovascular lesions received a single treatment with 24 Gy beta radiation (strontium-90) and two injections of Avastin (bevacizumab, Genentech).

Patients were enrolled to receive their first bevacizumab injection 10 days before surgery or at the time of surgery. However, there was poor compliance with the protocol for the pre-surgical injection group, and so all patients were considered in the analysis, the study authors said.

No radiation-associated adverse events were reported at 12 months. In an intent-to-treat analysis, which included eight patients who did not meet the protocol-specified eligibility criteria, 91% of patients lost less than three lines of vision, 68% maintained or improved vision and 38% gained at least three lines.

"Eight patients showed evidence of lesion reactivation based on [optical coherence topography] and fluorescein angiographic criteria, and required additional injections of bevacizumab," the study authors said.