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      Multifocal Electroretinogram Findings after Intravitreal Bevacizumab Injection in Choroidal Neovascularization of Age-Related Macular Degeneration

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          Abstract

          Purpose

          To evaluate the changes in multifocal electroretinogram (mfERG) and optical coherence tomography (OCT) after intravitreal bevacizumab injection in the treatment of age-related macular degeneration (AMD).

          Methods

          Twenty-one eyes with choroidal neovascularization secondary to AMD were studied before and after intravitreal bevacizumab injection for best corrected visual acuity (BCVA), OCT, and mfERG.

          Results

          The BCVA improved, while central macular thickness and total macular volume in OCT decreased after intravitreal bevacizumab injection ( p = 0.03, 0.01, and 0.01, respectively). In mfERG, the amplitude of P1, and implicit time of P1 and N1 indicated a statistically significant improvement of retinal response after intravitreal bevacizumab injection.

          Conclusions

          There is a potential role for mfERG in evaluating the effect on retinal function of intravitreal bevacizumab injection.

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          Prevalence of age-related macular degeneration in the United States.

          David Friedman, Benita J O'Colmain, Beatriz Mateos Muñoz … (2004)
          To estimate the prevalence and distribution of age-related macular degeneration (AMD) in the United States by age, race/ethnicity, and gender. Summary prevalence estimates of drusen 125 microm or larger, neovascular AMD, and geographic atrophy were prepared separately for black and white persons in 5-year age intervals starting at 40 years. The estimated rates were based on a meta-analysis of recent population-based studies in the United States, Australia, and Europe. These rates were applied to 2000 US Census data and to projected US population figures for 2020 to estimate the number of the US population with drusen and AMD. The overall prevalence of neovascular AMD and/or geographic atrophy in the US population 40 years and older is estimated to be 1.47% (95% confidence interval, 1.38%-1.55%), with 1.75 million citizens having AMD. The prevalence of AMD increased dramatically with age, with more than 15% of the white women older than 80 years having neovascular AMD and/or geographic atrophy. More than 7 million individuals had drusen measuring 125 microm or larger and were, therefore, at substantial risk of developing AMD. Owing to the rapidly aging population, the number of persons having AMD will increase by 50% to 2.95 million in 2020. Age-related macular degeneration was far more prevalent among white than among black persons. Age-related macular degeneration affects more than 1.75 million individuals in the United States. Owing to the rapid aging of the US population, this number will increase to almost 3 million by 2020.
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            Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration.

            Robert Avery, Dante J Pieramici, Melvin D Rabena … (2006)
            To report the short-term safety, biologic effect, and a possible mechanism of action of intravitreal bevacizumab in patients with neovascular age-related macular degeneration (AMD). Interventional, consecutive, retrospective case series. Eighty-one eyes of 79 patients with subfoveal neovascular AMD. Patients received intravitreal bevacizumab (1.25 mg) on a monthly basis until macular edema, subretinal fluid (SRF), and/or pigment epithelial detachment (PED) resolved. Ophthalmic evaluations included nonstandardized Snellen visual acuity (VA), complete ophthalmic examination, fluorescein angiography, and optical coherence tomography (OCT). Assessments of safety, changes in Snellen VA, OCT retinal thickness, and angiographic lesion characteristics were performed. No significant ocular or systemic side effects were observed. Most patients (55%) had a reduction of >10% of baseline retinal thickness at 1 week after the injection. At 4 weeks after injection, 30 of 81 eyes demonstrated complete resolution of retinal edema, SRF, and PEDs. Of the 51 eyes with 8 weeks' follow-up, 25 had complete resolution of retinal thickening, SRF, and PEDs. At 1, 4, 8,and 12 weeks, the mean retinal thickness of the central 1 mm was decreased by 61, 92, 89, and 67 mum, respectively (P<0.0001 for 1, 4, and 8 weeks and P<0.01 for 12 weeks). At 4 and 8 weeks, mean VA improved from 20/200 to 20/125 (P<0.0001). Median vision improved from 20/200 to 20/80(-) at 4 weeks and from 20/200 to 20/80 at 8 weeks. Short-term results suggest that intravitreal bevacizumab (1.25 mg) is well tolerated and associated with improvement in VA, decreased retinal thickness by OCT, and reduction in angiographic leakage in most patients, the majority of whom had previous treatment with photodynamic therapy and/or pegaptanib. Further evaluation of intravitreal bevacizumab for the treatment of choroidal neovascularization is warranted.
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              Short-term safety and efficacy of intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration.

              Ryan Rich, Philip J. Rosenfeld, Carmen A. Puliafito … (2015)
              To evaluate the safety and efficacy of intravitreal bevacizumab (Avastin, Genentech Inc.) for the treatment of neovascular age-related macular degeneration (ARMD). A retrospective review was performed on consented patients with neovascular ARMD receiving intravitreal bevacizumab therapy. All patients received intravitreal bevacizumab at baseline with additional monthly injections given at the discretion of the treating physician. At each visit, a routine Snellen visual acuity assessment was performed followed by an ophthalmic examination and optical coherence tomography (OCT) imaging. Fifty-three eyes of 50 patients received an intravitreal bevacizumab injection between May and August 2005. Including the month 3 visit, the average number of injections was 2.3 out of a maximum of 4 injections. No serious drug-related ocular or systemic adverse events were identified. Improvements in visual acuity and central retinal thickness measurements were evident by week 1 and continued through month 3. At month 3, the mean visual acuity improved from 20/160 to 20/125 (P < 0.001) and the mean central retinal thickness decreased by 99.6 microm (P < 0.001). Off-label intravitreal bevacizumab therapy for neovascular ARMD was well tolerated over 3 months with improvements in visual acuity and OCT central retinal thickness measurements. While the long-term safety and efficacy of intravitreal bevacizumab remain unknown, these short-term results suggest that intravitreal bevacizumab may be the most cost effective therapy for the treatment of neovascular ARMD.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Korean J Ophthalmol
                Journal ID (publisher-id): KJO
                Title: Korean Journal of Ophthalmology : KJO
                Publisher: The Korean Ophthalmological Society
                ISSN (Print): 1011-8942
                ISSN (Electronic): 2092-9382
                Publication date (Print): June 2011
                Publication date (Electronic): 24 May 2011
                Volume: 25
                Issue: 3
                Pages: 161-165
                Affiliations
                Department of Ophthalmology, Soonchunhyang University College of Medicine, Bucheon, Korea.
                Author notes
                Corresponding Author: Young-Hoon Ohn, MD, PhD. Department of Ophthalmology, Soonchunhyang University College of Medicine, #1174 Jung-dong, Wonmi-gu, Bucheon 420-767, Korea. Tel: 82-32-621-5053, Fax: 82-32-621-5018, yhohn@ 123456schmc.ac.kr
                Article
                DOI: 10.3341/kjo.2011.25.3.161
                PMC ID: 3102818
                PubMed ID: 21655040
                SO-VID: 940d39ae-0601-417e-b482-92e31b5e72f7
                Copyright © © 2011 The Korean Ophthalmological Society
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 12 July 2010
                Date accepted : 02 October 2010
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: choroidal neovascularization,age-related macular degeneration,multifocal electroretinogram,bevacizumab,optical coherence tomography
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: choroidal neovascularization, age-related macular degeneration, multifocal electroretinogram, bevacizumab, optical coherence tomography

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