Abstract

SO.08.06

OCT based anti-VEGF retreatment of neovascular ARMD

Schaal K. B., Höh A. E., Scheuerle A., Schütt F., Dithmar S.
Department of Ophthalmology, University of Heidelberg

Objective: Multicenter trials with Pegabtanib (Macugen^®) and Ranibizumab (Lucentis^®) had a strict schedule for reinjections (intervals: 6 or 4 weeks). This study examines whether it is possible to base reinjections on individual OCT findings.
Methods: In a prospective study, patients with active subfoveal occult choroidal neovascularization receive a single intravitreal injection of 1,25mg Bevacizumab. Retreatment is only performed if OCT findings show persistent or recurrent intra- or subretinal fluid. Time span between injections is at least 6 weeks. ETDRS visual acuity, ophthalmic examination and OCT are performed at baseline and subsequently every 6 weeks.
Results: In 39% (n=9) of 23 eyes enrolled so far, intra- and subretinal fluid had completely resolved after a single injection with no recurrence till now (follow-up of this group: 19±6 weeks). 9 eyes (39%) showed complete absence of fluid 6 weeks after first injection, but had a relapse within 15±3 weeks. After a second injection, the fluid resolved again in all eyes within 6 weeks. Another relapse occurred in two eyes within 11±4 weeks after the second injection requiring another injection. During the whole treatment visual acuity was stable in all patients, 26% gained ³3 lines.
Conclusions: OCT based Bevacizumab-retreatment of occult subfoveal CNV leads to anatomic as well as functional stabilisation. The total number of injections per patient can be reduced in comparison to a strict reinjection schedule. In all patients intravitreal Bevacizumab treatment resulted in stability or improvement of visual acuity.

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