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Systemic bevacizumab effective against PED secondary to AMD in small study
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Systemic treatment with bevacizumab improved vision and reduced lesion sizes in a small study of patients with pigment epithelial detachment secondary to age-related macular degeneration. All patients tolerated the intravenous drug infusions well, having no significant changes in systemic blood pressure, according to the study authors.
Matthias Bolz, MD, and colleagues at the Medical University of Vienna, Austria, conducted the prospective study, which included nine eyes of nine patients. All patients had neovascular AMD and were either not eligible for verteporfin (Visudyne, Novartis/QLT) photodynamic therapy (PDT) or refused treatment with PDT.
All eyes had pigment epithelial detachment (PED) identified by optical coherence tomography and choroidal neovascularization, as shown using fluorescein angiography. In eight eyes, the PED was secondary to a retinal angiomatous proliferation and one eye had a notch PED, according to the study.
Investigators treated five patients with three infusions of 5 mg/kg of bevacizumab (Avastin, Genentech) and four patients with three infusions containing 2.5 mg/kg of the drug. Each infusion was performed at 2 week intervals, the authors reported.
At baseline, PED height averaged 461.15 µm, PED greatest linear diameter averaged 3,008.38 µm, and best corrected visual acuity averaged 54 ETDRS letters.
Investigators found that the average maximum lesion height significantly decreased by 21% at 1 week post-treatment, by 32% at 2 weeks, by 46% at 6 weeks and by 39% at 3 months follow-up.
"Two PEDs resolved completely within the 3 months after initiation of treatment," the authors said.
Investigators also found a "distinct and close to significant decrease in maximum diameter" of 24% at 3 months follow-up, they noted.
In addition, patients had significant improvements in vision after initiating treatment. At 3 months follow-up, BCVA had improved an average of 12.7 letters to 66.7 letters, according to the study.
"A statistically significant difference was found as early as 2 weeks after initiation of therapy," the authors noted.
The study is published in the June issue of British Journal of Ophthalmology.