COMPARISON OF 2.5 mg/kg AND 5 mg/kg SYSTEMIC BEVACIZUMAB IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION

In Brief Background: To compare safety, visual acuity (VA), and anatomic outcomes of 2.5 mg/kg and 5 mg/kg intravenous bevacizumab in patients with neovascular age-related macular degeneration. Methods: In an institutional cohort study, 16 patients (2 cohorts, 27 eyes) with neovascular age-related macular degeneration were treated with 5 mg/kg intravenous bevacizumab and 2.5 mg/kg, respectively. All patients received 3 initial intravenous infusions at 2-week intervals. The main outcome measures were VA, optical coherence tomography, and fluorescein angiography. Results: No serious systemic or ocular adverse events were identified. By Day 7, mean VA increased from 56 letters (20/80+1) at baseline to 60 letters (20/63) in the 5 mg/kg group and mean central retinal thickness decreased by 83 μm. In the 2.5 mg/kg group, mean VA increased from 55 letters (20/80) to 66 letters (20/50+1) and mean central retinal thickness decreased by 93 μm. By Month 3, VA improved by 10 letters compared to baseline in the 5 mg/kg group and by 9 letters in the 2.5 mg/kg group. Central retinal thickness was reduced by 128 μm in the 5 mg/kg group and by 127 μm in the 2.5 mg/kg group. These benefits were sustained through 6 months. No statistically significant difference was found between both treatment groups regarding safety, VA, and anatomic outcomes. Conclusion: Similar VA, optical coherence tomography, and angiographic improvements were observed in both treatment groups up to 6 months. Further follow-up is required to evaluate the long-term durability and safety of both treatment regimens. Systemic 2.5 mg/kg and 5 mg/kg bevacizumab (Avastin®) was safe and improved vision and central retinal thickness in patients with neovascular age-related macular degeneration.