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.