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Br J Ophthalmol doi:10.1136/bjo.2008.144410

Systemic bevacizumab (Avastin®) Therapy for exudative neovascular age-related macular degeneration. The BEAT-AMD-study.

  1. Katharina E Schmid-Kubista (katharina.schmid-kubista{at}wienkav.at),
  2. Ilse Krebs (ilse.krebs{at}wienkav.at),
  3. Birgit Gruenberger (birgit.gruenberger{at}wienkav.at),
  4. Johann Schueller (johann.schueller{at}wienkav.at),
  5. Susanne Binder (susanne.binder{at}wienkav.at)
  1. Department of Ophthalmology, Rudolf Foundation Clinic, Austria
  2. Department of Ophthalmology, Rudolf Foundation Clinic, Austria
  3. Department of Internal Medicine, Oncology, Rudolf Foundation Clinic, Austria
  4. Department of Internal Medicine, Oncology, Rudolf Foundation Clinic, Austria
  5. Department of Ophthalmology, Rudolf Foundation Clinic, Austria
    • 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 neovascularization extending under the geometric centre of the foveal avascular zone, and/or macular thickness of at least 300µm in both eyes were included. Sixteen eyes were included and randomised equally to receive either 3 infusions of 5mg/kg Avastin or 100ml 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 weeks follow up the lesion size and the macular thickness decreased in the Avastin group by 0.5±0.08mm and 103.6+14.9µl respectively. In both groups visual acuity remained stable in 7 eyes and decreased in 1 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 an treatable rise in blood pressure after Avastin treatment.

    Conclusion: We suggest offering systemic Avastin 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.

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