Long-Term Follow-Up After Multiple Intravitreal Bevacizumab Injections for Exudative Age-Related Macular Degeneration

Abstract

To analyze the long-term effect of multiple intravitreal injections of bevacizumab as therapy of exudative age-related macular degeneration (AMD). The retrospective clinical interventional case series study included 45 patients (48 eyes) who received intravitreal injections of bevacizumab (1.5 mg) for treatment of exudative AMD and for whom the follow-up was >2 years. All patients received an initial series of 3 injections applied in intervals of 6-8 weeks. Subsequent injections were given in intervals ranging between 2 and 6 months. The mean number of all injections performed per eye was 8.6 +/- 2.5. The mean follow-up was 27.8 +/- 3.6 months. The main outcome parameters were best-corrected visual acuity (BCVA) and foveal thickness measurements by optical coherence tomography (OCT). Mean BCVA improved from 0.62 +/- 0.30 LogMAR at baseline to 0.55 +/- 0.28 LogMAR (P = 0.03) at 1 month after the 3 initial injections. At the end of follow-up, BCVA decreased significantly (P = 0.02) to 0.76 +/- 0.41 LogMAR. Bivariate correlation tests showed that the change in BCVA from baseline to the final examination at the end of follow-up was significantly associated only with the baseline BCVA (correlation coefficient r = 0.39, P = 0.006). The height of the subretinal fluid reduced significantly (P = 0.004) at 1 month after the 3 initial injections and remained so till the final follow-up (P = 0.01). Multiple intravitreal bevacizumab injections initially led to an improvement in visual acuity, finally, however, failed to stabilize visual acuity after a follow-up of >2 years.