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Effect of systemic bevacizumab therapy on retinal pigment epithelial detachment
  1. Matthias Bolz,
  2. Stephan Michels,
  3. Wolfgang Geitzenauer,
  4. Franz Prager,
  5. Ursula Schmidt-Erfurth
  1. Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
  1. Correspondence to: Stephan Michels Department of Ophthalmology, Medical University of Vienna, Währinger Gürtel 18–20, 1090 Vienna, Austria; Stephan.michels{at}meduniwien.ac.at

Abstract

Background: To evaluate the effect of systemic bevacizumab (Avastin®) therapy on pigment epithelial detachment (PED) secondary to age-related macular degeneration (AMD) and to identify prognostic factors for PED regression and improvement in best corrected visual acuity (BCVA).

Study design: Prospective uncontrolled pilot study.

Methods: Nine patients (nine eyes) received three systemic bevacizumab treatments at 2 week intervals and were examined at baseline, weeks 1, 2, 4, 6 and month 3 by using optical coherence tomography (Stratus OCT™, Carl Zeiss© Meditec, Dublin, California, USA). Changes in maximum PED height and greatest linear diameter (GLD) were planimetrically analysed by using Adobe Photoshop CS and correlated with retinal morphological changes and changes in BCVA.

Results: Systemic bevacizumab therapy was well tolerated. Mean maximum PED height decreased significantly by 21% as early as 1 week (−96 µm (SD 48.8), p<0.01). At 3 months follow-up, two PEDs resolved completely, mean maximum PED height decreased significantly by 39% (−179 µm (SD 178), p = 0.02) and mean PED GLD by 24% (−714 µm (SD 1010), p = 0.07). Mean BCVA improved significantly by week 2 (+8.7 letters (SD 5.7), p<0.01) and at 3 months with 12.7 letters (SD 6.4) (p<0.01).

Conclusion: In the examined nine patients, systemic bevacizumab therapy showed evidence for an effect on PED secondary to neovascular AMD in terms of a decrease in lesion height and diameter. A high PED at baseline was found to be a negative predictive factor for visual outcome.

  • AMD, age-related macular degeneration
  • BCVA, best corrected visual acuity
  • CNV, choroidal neovascularisation
  • ETDRS, early treatment diabetic retinopathy study
  • GLD, greatest linear diameter
  • PED, pigment epithelial detachment
  • VEGF, vascular endothelial growth factor
  • OCT, optical coherence tomography
  • AMD
  • PED
  • VEGF
  • bevacizumab
  • OCT
  • AMD, age-related macular degeneration
  • BCVA, best corrected visual acuity
  • CNV, choroidal neovascularisation
  • ETDRS, early treatment diabetic retinopathy study
  • GLD, greatest linear diameter
  • PED, pigment epithelial detachment
  • VEGF, vascular endothelial growth factor
  • OCT, optical coherence tomography
  • AMD
  • PED
  • VEGF
  • bevacizumab
  • OCT

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Footnotes

  • Published Online First 18 October 2006

  • Funding: this study was supported financially by the Austrian National Bank (Jubilaeumsfonds: project number 11857) and by the “Buergermeisterfond” of Vienna (project number 2445).

  • Competing interests: None.

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