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Br J Ophthalmol 2009;93:914-919 doi:10.1136/bjo.2008.144410
  • Clinical science
  • Original Article

Systemic bevacizumab (Avastin) therapy for exudative neovascular age-related macular degeneration. The BEAT-AMD-Study

  1. K E Schmid-Kubista1,
  2. I Krebs1,
  3. B Gruenberger2,
  4. F Zeiler1,
  5. J Schueller2,
  6. S Binder1
  1. 1
    Department of Ophthalmology, The Ludwig Boltzmann Institute for Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic, Vienna, Austria
  2. 2
    Department of Internal Medicine, Oncology, Rudolf Foundation Clinic, Vienna, Austria
  1. Dr K E Schmid-Kubista, Department of Ophthalmology, Ludwig Boltzmann Institute for Retinology and Biomicroscopic Lasersurgery, Rudolf Foundation Clinic, Juchgasse 25, 1030 Vienna, Austria; katharina.schmid-kubista{at}wienkav.at
  • Accepted 9 February 2009
  • Published Online First 29 April 2009

Abstract

Background: Double-blinded, randomised, prospective, pilot-study to determine the effect of systemic bevacizumab therapy.

Methods: Subjects with fibrovascular pigment epithelial detachment, subfoveal choroidal neovascularisation extending under the geometric centre of the foveal avascular zone and/or macular thickness of at least 300 μm in both eyes were included. Sixteen eyes were included and randomised equally to receive either three infusions of 5 mg/kg Avastin or 100 ml of 0.9% sodium chloride every 2 weeks. The main outcome measure was the lesion size. The follow-up time was 24 weeks.

Results: Throughout the 24-week follow-up, the lesion size and macular thickness decreased in the Avastin group by 0.5 (SD 0.08) mm and 103.6 (14.9) μl respectively. In both groups, visual acuity remained stable in seven eyes and decreased in one eye. At the end of follow-up, 50% of the eyes in the Avastin group became fibrotic, 37.5% remained unchanged, and 12.5% developed a subretinal bleeding. There was a treatable rise in blood pressure after Avastin treatment.

Conclusion: Systemic Avastin could be offered to patients with exudative age-related macular degeneration in both eyes and/or patients who refuse intravitreal injections if blood pressure is normal and there is no history of thrombosis.

Footnotes

  • Competing interests: None.

  • Funding: There was financial support by the “Scientific Grant of the Mayor of Vienna,” received in June 2006.

  • Ethics approval: Ethics approval was provided by the Ethics Committee of the City of Vienna.

  • Patient consent: Obtained.

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