Article Text

Download PDFPDF
A study comparing two protocols of treatment with intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration
  1. L Arias1,2,
  2. J M Caminal1,
  3. L Casas3,
  4. C Masuet3,
  5. M B Badia4,
  6. M Rubio1,
  7. O Pujol1,
  8. J Arruga1
  1. 1
    Department of Ophthalmology. Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
  2. 2
    Institut de la Màcula i de la Retina, Centro Médico Teknon, Barcelona, Spain
  3. 3
    Department of Preventive Medicine, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
  4. 4
    Department of Pharmacy. Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
  1. Dr L Arias, Department of Ophthalmology, Hospital Universitari de Bellvitge, C/Feixa Llarga, sn, 08907 – L’Hospitalet de Llobregat, Barcelona, Spain; luisarias{at}


Aims: The aim of this study was to compare two treatment options for choroidal neovascularisation (CNV) secondary to age-related macular degeneration (AMD): (1) bevacizumab administered once a month for 3 months and thereafter as needed (loading dose (LD)); and (2) bevacizumab administered as needed, after the first injection (pro re nata (as needed) (PRN)).

Methods: Fifty consecutive patients were enrolled in this prospective study. The first 25 patients were included in the LD group and the last 25 patients in the PRN group. In both groups, the need for re-treatment was based on the presence of persistent or recurrent macular oedema, subretinal fluid or pigment epithelial detachment on optical coherence tomography scans.

Results: At the 6-month follow-up, mean visual acuity improved by 13.7 letters (p<0.001) in the LD group and 4.6 in the PRN group (p<0.001). Thirty-six per cent of patients in the LD group compared with 12% in the PRN group gained 15 or more letters (p = 0.04). Mean foveal thickness decreased by 91.3 µm (p<0.001) in the LD group and 48.2 µm in the PRN group (p<0.001). No ocular or systemic side effects were observed.

Conclusion: Patients with CNV secondary to AMD treated with a LD protocol had better results than patients treated with a PRN protocol with intravitreal bevacizumab.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • English editing of this manuscript: American Journal Experts

  • Funding: None.

  • Competing interests: None declared.

  • Ethics approval: The institutional review board of the Hospital Universitari de Bellvitge approved this study. As intravitreal use of bevacizumab is not approved in Spain, we obtained a compassionate use indication from the Ministerio de Sanidad y Consumo (Ministry of Health and Consumer Affairs) before initiating the study.

  • Patient consent: Obtained.

Linked Articles

  • At a glance
    Harminder S Dua Arun D Singh