Session Title: AMD I
Session Date/Time: Friday 12/09/2014 | 08:00-10:00
Paper Time: 08:40
Venue: Boulevard C
First Author: : A.Rosenblatt ISRAEL
Co Author(s): : G. Lavi G. Rabina R. Kehat O. Rubalski A. Loewenstein
The purpose of this study is to evaluate the long term effectiveness of Bevacizumab administered in a Pro Re Nata (PRN) regimen for SFCNV secondary to neovascular AMD.
The Ophthalmology clinic of the Tel Aviv Sourasky Medical Center (Ichilov)
This was a single centered retrospective cohort study. We reviewed the records of all patients with a diagnosis of SFCNV due to AMD who were treated with Bevacizumab between 01/2006 – 12/2012. inclusion criteria included : age >50 with diagnosis of SFCNV due to AMD, with no previous treatment, and that were examined at least every 3 months with a follow up of at least 2 years. The study excluded eyes with other retinal pathologies such as Diabetic macular edema, retinal vein occlusion, and s/p retinal surgeries. At each visit best corrected visual acuity (BCVA) , Fundus examination.) , Number of Bevacizumab injections, and adverse events were recorded Central macular thickness (CMT) evaluated on Optical Coherence Tomography (OCT) was frequently performed in concordance with common clinical practice in our clinic. Primary outcomes measurements were the change in (BCVA) and change in CMT from baseline to the end of the follow up. Snellen BCVA was converted for statistical analysis to LogMar and CMT was measured on Stratus OCT until 10/2009, and then on SD Spectralis OCT.
126 eyes of 104 patients were included in the analysis. There were 35.7%. The mean age was 78.05y (Sd 8.8). At baseline, the mean visual acuity was 0.65 (Sd 0.4) LogMar and the mean CMT was 391.3 (Sd 171). The mean follow up time was 32.9 m (Sd 11.3), and during that time the mean number of Bevacizumab injections was 15.4 Sd 7.4). At the end of follow up mean visual acuity slightly improved compared to baseline and was 0.72 (Sd 0.6) LogMar with no statistically difference compared to baseline (Pv=0.127) Furthermore during the follow-up period 22.5% of patients switched form Bevacizumab treatment to Ranibizumab and an additional 4.7% stop treatment due to visual loss
Despite the favorable visual and anatomical outcomes after a short to medium Bevacizumab treatment seen in previous studies it seems, in our study that the long term effect of Bevacizumab is reduced. The improvement in visual acuity does not last and the final visual acuity is not significantly different compared to baseline. Larger scale prospective studies are needed to establish long term treatment benefits.