Aims: To determine the characteristics of "non-responders" to intravitreal bevacizumab treatment in choroidal neovascularisation (CNV).
Methods: Forty-three patients with visual loss due to neovascular age-related macular disease (ARMD) (44 eyes) underwent intravitreal injections of 1.25 mg (0.05 ml) bevacizumab and were followed up every 4 weeks for 2, 3, or 6 months. Reinjection was performed when persistent leakage of the CNV was determined by fluorescein angiography, and retinal oedema was assessed by optical coherence tomography (OCT). Non-responders were defined as those patients having reduced or stable visual acuity at the last follow-up.
Results: Forty-five per cent of the patients were non-responders. In this group the initial CNV size was significantly larger than in the responders. Initial reading ability was significantly lower in non-responders, but the initial foveal oedema was similar in both groups. Gains in mean visual acuity and reading ability were independent of lesion type. The proportion of non-responders to responders in the different lesion type groups was equally distributed. Only patients with the classic type of CNV seemed to respond better.
Conclusions: In this study initial reasons for "non-responders" to intravitreal bevacizumab treatment in CNV are given. The efficiency of bevacizumab depends on initial lesion size and initial reading ability, but is independent of the amount of intra- and subretinal fluid. There was no general ineffectiveness of bevacizumab with any particular lesion type.
- age-related macular degeneration
- anti-VEGF therapy
- optical coherence tomography