ROLE OF INTRAVITREAL BEVACIZUMAB INJECTION FOR MANAGEMENT OF NEOVASCULAR AGE RELATED MACULAR DEGENERATION

Abstract

Background: Age related macular degeneration (ARMD ) is the major cause of severe visual loss in older adults.Different treatment modalities are available such as: Laser photocoagulation,photodynamic therapy,transpupillary thermotherapy,submacular surgery & anti-vegf.

Aims & Objectives: The aim of our study was to evaluate the efficacy and safety of intravitreally administered Bevacizumab a humanized monoclonal anti –VEGF in Neovascular Age related Macular Degeneration.

Methodology: This non randomized, prospective study was carried out on 75 eyes of 75 patients attending the OPD at M & J Institute Of Ophthalmology and diagnosed as having Neovascular ARMD confirmed on FFA and SD-OCT . After taking written informed consent all patients were injected with intravitreal Bevacizumab 1.25 mg/0.05 ml. Follow up visits were scheduled one week, one month postprocedure and every monthly thereafter.

Results: 75 eyes of 75 patients were included in this non randomized prospective study. & 29.33% patients required 2 injections. Visual acuity is improved more than 3 lines from baseline in 21.33% patient, 64% patient have 2-3 lines gain & 6.66% patients showed 0-1 line gain in snellen’s visual acuity. 5.33% patients have a loss of 1 line from baseline & 2.66% patients showed loss of 2-3 lines. Central foveal thickness decreased more than 200 microns from baseline in 52% patients, 28% patients have decreased of 100-200 microns & 20% patients have decreased of less than 100 microns.

Discussion: Approximately 10 % of ARMD patients manifest the neovascular form of the disease. 12 weeks). Our study showed that 80% patients had decrease in central foveal thickness more than 100 microns from baseline at the end of one year. 85% patients had gain of 2 or more lines on Snellen’s visual acuity chart from baseline.No patient had any serious local or systemic adverse reactions.Limitations of our study is small number of patients,ICG not done,not compared with other anti-vegf drugs.

Conclusion: Intravitreal Bevacizumab is a safe and effective drug in treatment of neovascular age related macular degeneration without any serious systemic or local adverse effects