INTRAVITREAL BEVACIZUMAB FOR CHOROIDAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION: 5-Year Results of The Pan-American Collaborative Retina Study Group
Abstract
In Brief Purpose: To report the long-term anatomical and functional outcomes of patients with choroidal neovascularization secondary to age-related macular degeneration treated with intravitreal bevacizumab (IVB). Methods: Retrospective case series. Patients diagnosed with subfoveal choroidal neovascularization secondary to age-related macular degeneration that were treated with at least 1 intravitreal injection of 1.25 mg of IVB and had a minimum follow-up of 60 months. Patients underwent best-corrected Snellen visual acuity testing, optical coherence tomography, and ophthalmoscopic examination at baseline and follow-up visits. Results: Two hundred and forty-seven consecutive patients (292 eyes) were included. The mean number of IVB injections per eye was 10.9 ± 6.4. At 5 years, the BCVA decreased from 20/150 (logMAR 0.9 ± 0.6) at baseline to 20/250 (logMAR 1.1 ± 0.7) (P = <0.0001). The mean CMT decreased from 343.1+ 122.3 μm at baseline to 314.7 ± 128.8 μm at 60 months of follow-up (P = 0.009). Geographic atrophy (GA) was observed at baseline in 47 (16%) of 292 eyes. By 5 years, GA developed or progressed in 124 (42.5%) of 292 eyes (P < 0.0001). Conclusion: The early visual gains obtained from IVB were not maintained at 5 years of follow-up. In addition, IVB may play a role in the development or progression of GA. Neovascular age-related macular degeneration is a chronic condition that requires aggressive monitoring and treatment if early functional gains are to be maintained. Pro re nata treatment of exudative AMD is not sufficient to maximize the long-term visual outcomes.
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In an Australian retrospective review, patients frequently stop attending care shortly after their vision declines.
“patients who stop returning for care often do so soon after losing vision”
From Five-Year Outcomes with Anti–Vascular Endothelial Growth Factor Treatment of Neovascular Age-Related Macular Degeneration (2016) · cites this paper as [18]
Multiple large retrospective or registry studies have published 4- and 5-year results.
“Several large-scale retrospective or registry studies have reported 4- and 5-year outcomes”
From Five-Year Outcomes with Anti–Vascular Endothelial Growth Factor Treatment of Neovascular Age-Related Macular Degeneration (2016) · cites this paper as [18]
In the Pan-American Study, the mean number of injections over 5 years was 11 and mean visual acuity at 5 years was 20/250.
“In contrast, the mean number of injections was 11 over 5 years in the Pan-American Study and the mean visual acuity at 5 years was 20/250.18”
From Five-Year Outcomes with Anti–Vascular Endothelial Growth Factor Treatment of Neovascular Age-Related Macular Degeneration (2016) · cites this paper as [18]
Patients with better vision are over-represented in retrospective/registry studies of long-term anti-VEGF outcomes.
“so that patients with better vision are over-represented in these studies.”
From Five-Year Outcomes with Anti–Vascular Endothelial Growth Factor Treatment of Neovascular Age-Related Macular Degeneration (2016) · cites this paper as [18]
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- Authors
- Arevalo, J. F., Lasave, A. F., Wu, L., Acón, D., Berrocal, M. H., Diaz-Llopis, M., Gallego-Pinazo, R., Serrano, M. A., Alezzandrini, A. A., Rojas, S., Maia, M., & Lujan, S.
- Affiliations
- Johns Hopkins University (US)
- Venue
- Retina
- Published
- 2016-05
- Volume
- 36
- Issue
- 5
- Pages
- 859-867
- ISSN
- 0275-004X (ISSN-L)
- OpenAlex
- W2188870890
- Cited by
- 60
- References
- 30
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 5 · 2023: 2 · 2022: 5 · 2021: 9 · 2020: 7 · 2019: 6 · 2018: 7 · 2017: 9 · 2016: 2
- FWCI
- 5.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Retina (publishedVersion)
- PubMed (publishedVersion)
- UNIFESP Institutional Repository (Universidade Federal de São Paulo) (submittedVersion)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal and Macular Surgery
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Keywords
- intravitreal bevacizumab, choroidal neovascularization, neovascular age-related macular degeneration, geographic atrophy, visual acuity outcomes, central macular thickness, long-term treatment outcomes, anti-VEGF therapy
- MeSH terms
- Bevacizumab, Aged, Aged, 80 and over, Female, Fluorescein Angiography, Humans, Macular Degeneration, Male, Middle Aged, Ophthalmoscopy, Retrospective Studies, Visual Acuity, Treatment Outcome, Choroidal Neovascularization, Angiogenesis Inhibitors, Tomography, Optical Coherence, Vascular Endothelial Growth Factor A, Geographic Atrophy, Intravitreal Injections
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