Intravitreal bevacizumab treatment for exudative age-related macular degeneration with good visual acuity

To investigate the effect of intravitreal bevacizumab on the visual and anatomic outcome of patients with exudative age-related macular degeneration presenting with good visual acuity (VA).

A file review was performed for all consecutive patients with newly diagnosed exudative age-related macular degeneration and initial VA of ≥ 20/40 treated in 2005 to 2010 and followed for at least 6 months. Treatment consisted of 3 loading doses of intravitreal bevacizumab every 6 weeks and was repeated when fluid or hemorrhage was present.

The cohort included 130 patients (150 eyes). Mean follow-up was 20.2 ± 13.2 months, and mean number of injections was 11.3 ± 6.2. At the last examination, VA was stable or improved in 106 eyes (70.7%); 11 eyes (7.3%) lost ≥ 3 lines. Mean logarithm of the minimum angle of resolution VA measured 0.22 ± 0.1 (0-0.3) at presentation and 0.22 ± 0.2 (0-1.3) at the last visit. Corresponding values for central macular thickness were 267 ± 75 μm (137-562) and 226 ± 75 μm (75-568) (P = 0.14). The most frequent complication (18 eyes, 12%) was corneal epithelial defects.

Prompt intravitreal bevacizumab treatment for newly diagnosed exudative age-related macular degeneration in patients with good initial best-corrected visual acuity is associated with sustained or improved vision and a good safety profile. Attempts should be made to expedite the access of these patients to treatment, regardless of initial VA.