Intravitreal Bevacizumab for Treatment of Neovascular Age-related Macular Degeneration: The Second Year of a Prospective Study

PURPOSE: To demonstrate the efficacy of intravitreal bevacizumab for treatment of neovascular age-related macular degeneration (AMD). DESIGN: Prospective, open-label, nonrandomized clinical study. METHODS: Fifty,one patients (51 eyes) with subfoveal choroidal neovascularization (CNV) resulting from AMD participated in this study at the American University of Beirut and Hotel Dieu de France Retina Clinics. These patients had already completed 12 months of follow-up. The criteria for reinjection were presence of fluid in the macula, increased central retinal thickness (CRT) of at least 100 mu m, loss of at least 5 letters of vision associated with increased fluid in the macula, new classic CNV, or new macular hemorrhage. The main outcome measure was the proportion of eyes losing fewer than 15 letters of vision after 12 months. RESULTS: Fifty-one patients (51 eyes) completed the additional 12 months. Mean visual acuity improved from 45.7 letters at baseline to 54.3 letters at 24 months (P = .001), and 47 eyes (92.2%) lost fewer than 15 letters. Mean CRT decreased from 327.4 mu m at baseline to 246.6 mu m at 24 months (P < .001). A mean of 1.5 injections were administered over the course of the second year. No serious ocular or systemic side effects were noted. CONCLUSIONS. Eyes with neovascular AMD treated with intravitreal bevacizumab over 2 years had significant anatomic and functional improvement compared with baseline. Further studies are necessary to confirm the long,term efficacy and safety of this treatment. (Am J Ophthalmol 2009;148:59-65. (C) 2009 by Elsevier Inc. All rights reserved.)