Objective To observe the effect of intravitreal bevacizumab (IVB) for exudative age-related macular degeneration (eAMD), and analyze the reasons for treatment failure. Methods Eighteen eyes of 17 patients with eAMD who have been diagnosed by fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were enrolled in this openlabel, single treatment group and prospective study. The patients received the first IVB treatment after diagnosis, and received the 2nd, 3rd, 4th, 5th and 6th IVB treatment at 6, 12, 24, 36, 48 weeks after the first injection. The examinations of best corrected visual acuity (BCVA), intraocular pressure, slit lamp microscope, fundus photography, FFA, ICGA and OCT were performed before and after treatment. Non-responders were defined as patients who had BCVA loss more than 5 letters at week 52 compared with BCVA before treatment. The therapeutic effects of IVB for eAMD were observed. The central macular thickness (CMT), maximum retinal thickness (MRT) and morphological changes of FFA, ICGA and OCT before and after treatment were comparative analyzed. Results Of the 18 eyes, 12 eyes (66.67%) were effective to IVB, 6 eyes (33.33%) were non-responders. The average CMT and MRT of non-responders were 506.83, 635.33 mu;m before treatment, which decreased to 446.17, 563.67 mu;m at 52 weeks. They were reduced by 60.67 and 71.67 mu;m respectively, but there was no statistically significant differences (t=-1.572,-0.943; P=0.116, 0.345). FFA and ICGA examination found that the CNV lesions of 3 non-responder eyes located in the foveal region, and became scars after the 6th treatment. The other 3 non-responder eyes developed CNV repeatedly during the treatments, and after the 6th injections of bevacizumab the lesions were under control with less fluorescein leakage and macular retinal edema. ConclusionIVB treatment is effective for some eAMD patients, but is ineffective for patients with extensive expanded CNV and foveal CNV.
Citation： 杨诚,于珊珊,周焕娇,黄永胜,孙刚,张熙芳,魏丽清,梁小玲. Therapeutic effects of intravitreal injection of bevacizumab on exudative age-related macular degeneration and non-responders analysis. Chinese Journal of Ocular Fundus Diseases, 2011, 27(6): 529-533. doi: Copy