Long-term follow-up after multiple intravitreal bevacizumab injections for exudative age-related macular degeneration.

Objective: To analyze the long-term effect of multiple intravitreal injections of bevacizumab as therapy of exudative age-related macular degeneration (AMD).

Methods: The retrospective clinical interventional case series study included 45 patients (48 eyes) who received intravitreal injections of bevacizumab (1.5 mg) for treatment of exudative AMD and for whom the follow-up was >2 years. All patients received an initial series of 3 injections applied in intervals of 6-8 weeks. Subsequent injections were given in intervals ranging between 2 and 6 months. The mean number of all injections performed per eye was 8.6 +/- 2.5. The mean follow-up was 27.8 +/- 3.6 months. The main outcome parameters were best-corrected visual acuity (BCVA) and foveal thickness measurements by optical coherence tomography (OCT).

Results: Mean BCVA improved from 0.62 +/- 0.30 LogMAR at baseline to 0.55 +/- 0.28 LogMAR (P = 0.03) at 1 month after the 3 initial injections. At the end of follow-up, BCVA decreased significantly (P = 0.02) to 0.76 +/- 0.41 LogMAR. Bivariate correlation tests showed that the change in BCVA from baseline to the final examination at the end of follow-up was significantly associated only with the baseline BCVA (correlation coefficient r = 0.39, P = 0.006). The height of the subretinal fluid reduced significantly (P = 0.004) at 1 month after the 3 initial injections and remained so till the final follow-up (P = 0.01).

Conclusions: Multiple intravitreal bevacizumab injections initially led to an improvement in visual acuity, finally, however, failed to stabilize visual acuity after a follow-up of >2 years.