The efficacety in administration of Avastin (Bevacizumab) in age related macular degeneration

Abstract

Introduction: One of the most important problems of the modern ophthalmology is the exudative form of Age Related Macular Degeneration (ARMD). Aim: The efficacy appreciation of the anti-VEGF treatment in the exudative form of ARMD. The material and methods: The study included 28 patients (28 affected eyes) affected by ARMD the exudative form, surveyed and treated in the Ophthalmology Clinic Nr.2 of SUMPh “Nicolae Testemitanu”. The patients were divided in 2 groups: basic group 15 patients - 3 men and 12 women and witness group 13 patients - 4 men and 9 women, medium age 72±2 years. The examination was performed before and after the treatment: VA - with and without correction; Amslers test; Sleet lamp examination of all eye’s segments in maximal midriasis, including Volk lens examination; macular photography; OCT; computer perimetria for 10° and 60°; fluorescent angiography. The 15 patients (15 affected eyes) from the basic lot were treated by intravitrian injection of Avastin: 8 patients 1 dose, 3 patients 2 doses with one month distance; 4 patient 3 doses 1 month distance. Results: During Avastin injection and postoperative period, no complications were noted. Avastin (Bevacizumab) application was evaluated by repeated examinations. VA with correction, increased in 60% of the cases (6 affected eyes) from 0,04-0.09, a week after the injection, up to 0.09-0.16 in 14 days after the injection and up to 0.16-0.25, a month past after the first injection. In 40% of the cases (4 affected eyes), visual acuity rested unchanged. Central scotoma surface diminished in 70% of the cases (7 eyes) and rested unchanged in 30% (3 affected eyes) at a month after the first injection. At OCT examination of the macula it has been determined a significant diminishment of Macula Edema (ME) adjustment of the detached neuroepithelium and retinal pigmented epithelium, diminution of the vascular complex and general thickness of the macular zone: from 550±30mkm to 260±30mkm in 90% (9 eyes) and just in 1 case it rested unchanged. After the second injection at 2 patients (2 affected eyes), we remarked an acuity raise with 0.06-0.1 and a diminution of the edema from 280±30mkm to 210±30mkm. In the first case we repeated the injection 3 times with 1 month interval: ME diminished in 3 months from 730mkm to 340mkm. Traditional treated patients had no visual acuity rise and no ME diminution (OCT data used). Conclusion: Effectuating this study we established that the use of Avastin (Bevacizumab) in the treatment of ARMD the exudative form is effective, comparatively with the traditional treatment.