Best corrected visual acuity improvements and safety outcomes in a 12-month trial suggested intravitreal bevacizumab to be an efficacious treatment for subfoveal idiopathic choroidal neovascularization.
Forty patients were given a single 1.25-mg injection of Avastin (bevacizumab, Genentech) followed by as-needed dosing in this prospective, nonrandomized, interventional case series. Presence and recurrence of intraretinal edema, subretinal fluid or pigment epithelial detachment, as shown by optical coherence tomography evaluations performed monthly, indicated re-treatment.
BCVA improved from 0.53 logMAR at baseline to 0.29 logMAR (P < .001), and mean central retinal thickness decreased from 321 µm to 237 µm (P < .001). All eyes experienced stable or improved vision, and 70% demonstrated a two-line improvement or better. After a mean of two injections, all lesions were in the cicatricial stage of choroidal neovascularization, and no drug-related systemic or ocular side effects occurred.
According to the study authors, outcomes were consistent with those already published; however, large, randomized, controlled, long-term trials are needed to further evaluate efficacy and determine optimal administration strategy.
In addition to size and follow-up, the study was limited by its lack of a control group; given the relatively good prognosis of untreated idiopathic choroidal neovascularization, the effects of bevacizumab cannot be fully gauged in a non-comparative study, the authors said.