Eyes with choroidal neovascularization due to age-related macular degeneration treated with intravitreal bevacizumab had marked anatomic and visual improvement, according to researchers at American University of Beirut and St. Joseph University in Lebanon.

The prospective, interventional case series included 17 eyes of 17 patients with subfoveal CNV due to AMD. All of the patients had failed, refused or were not eligible for photodynamic therapy. All eyes received a baseline eye exam, including best corrected visual acuity, dilated fundus exam, ocular coherence tomography, and fluorescein angiography.

An intravitreal injection of bevacizumab (2.5 mg/0.1 ml) was given at baseline and followed by two additional injections at four-week intervals, the researchers report. BCVA, OCT and FA were repeated four weeks after each injection.

The researchers noted improvement in BCVA and central retinal thickness. Mean baseline BCVA was 20/252 (median 20/200) and baseline CRT was 362 µm (median 350 µm). Improvement in VA and CRT occurred by week four. At 12 weeks, mean BCVA was 20/76 (p<0.001) and median BCVA was 20/50 (p<0.001). Both mean and median CRT decreased to 211 µm (p<0.001). Thirteen of 17 eyes had total resolution of subretinal fluid, and four eyes had BCVA better than 20/50. No systemic or ocular side effects were noted at any time, the researchers say.

The researchers add that because of the small sample size and the short follow-up, they were unable to draw conclusions regarding long-term efficacy and safety of intravitreal bevacizumab. They suggest longer follow-up to determine the long-term safety of the treatment and to determine the ideal dosage. The researchers would also like to compare intravitreal bevacizumab with other anti-VEGF treatments such as pegaptanib sodium and ranibizumab.

(Am J Ophthalmol 2006;142:1-9)
Bashshur ZF, Bazarbachi A, Schakal A, Haddad ZA, El Haibi CP, Noureddin BN.

Smoking, Other Factors Contribute to Patient Noncompliance

Patients who smoke, live alone or don't have access to a car are more likely to be noncompliant with follow-up than those who don't smoke, do not live alone or have a car, say researchers from Yale University School of Medicine.

The researchers were looking to evaluate the variables associated with failure to access free eye care after participating in a glaucoma screening.  The researchers studied 273 surveys completed by participants of African descent, age 40 years or older, who participated in community glaucoma screening clinics. Each participant was given a preliminary diagnosis and encouraged to attend a free eye clinic for a complete examination. Survey results were correlated with attendance at the follow-up examination, using Student's t test, chi-square test and logistic regression analysis.

When adjusting for risk factors in logistic regression analysis, noncompliance was associated with living alone (p=0.008), smoking (p=0.0005) and lacking a car (p<0.01). Odds of noncompliance for participants living alone were 2.2 times higher than those for participants not living alone. Odds of noncompliance for participants who smoked were three times greater than those for participants who did not smoke. Odds of noncompliance for participants who did not have access to a car for their last eye examination were 2.1 times greater than those for participants who did.

(Ophthalmology 2006;113:1315-1319)
Gwira JA, Vistamehr S, Shelsta H, Bashford K, Forster S, Palmisano P, Shafranov G, Shields MB.