Avastin: The Dunedin Experience

Abstract

Background: Neovascular age-related macular degeneration (AMD) is a blinding disease. Better understanding of the role of vascular endothelial growth factor (VEGF) in the pathogenesis of the condition has lead to the development of new treatments. The introduction of these anti-VEGF therapies has revolutionised clinical ophthalmology. Bevacizumab has been used off-label as one such treatment. While initially used solely for neovascular AMD, anti-VEGF treatments have become increasingly used for other ocular diagnoses with varying success.

Aim: To investigate the efficacy and safety of intravitreal bevacizumab treatment for a number of ocular diagnoses.

Methods: A retrospective review was completed of all eyes given intravitreal bevacizumab in the Eye Department, Dunedin Hospital, between November 2005-June 2008. Eyes included in the review had received at least one injection and had been followed up for at least one month.

Results: Eight hundred and fifty-four injections in 363 eyes were included in the study. The mean age of the population was 74 years and mean length of follow-up was 379 days. The largest diagnostic subgroup was neovascular AMD, making up 58.7% of the study population. In this group 62.9% of eyes showed improvement or stabilisation of best-corrected visual acuity (BCVA) with treatment. The mean change in BCVA was -0.19 Snellen chart lines. Other major subgroups were retinal vein occlusions and diabetic retinopathy. These groups showed improvement in BCVA of 0.45 and 0.33 Snellen chart lines respectively. Eyes with proliferative diabetic retinopathy improved 2.42 lines and diabetic maculopathy 0.29 lines. The rate of serious adverse events was low, with one case of sterile endophthalmitis recorded.

Conclusion: Intravitreal bevacizumab is a safe and effective treatment in a number of ocular diagnoses.