EFFECT OF INTRAVITREAL BEVACIZUMAB ON VISUAL ACUITY AND OPTICAL COHERENCE TOMOGRAPHY (OCT) CHANGES IN WET AGE-RELATED MACULAR DEGENERATION

Abstract

Lekshmi Priya Karthikeyan Radhamma, Maria Tinu Panakal George, Pappa Padmavathy, Rajini Konayi Cherayath

BACKGROUND Age-related Macular Degeneration (AMD) is the leading cause of blindness in patients over the age of 60 years. AMD associated with vision loss are divided into Atrophic (Dry) type and Neovascular (Wet) type. Intravitreal anti-vascular endothelial growth factor agents are used in the treatment of choroidal neovascularisation secondary to Wet AMD. This study was done to evaluate the improvement in visual acuity and OCT changes in Wet AMD after the intravitreal injection of bevacizumab (Avastin). METHODS Retrospective cohort study was conducted on a total of 50 eyes of 50 patients. Informed consent was taken. Detailed ocular examination was done. Spectral Domain OCT was carried out to diagnose and monitor the improvement of choroidal neovascularisation and sub retinal fluid (SRF). Data was analysed using SPSS 21.0 version software. RESULTS Majority of the patients (48%) belongs to 61-70 age category. 56% were male patients. Amsler Grid showed that 18 patients had metamorphopsia and 20 had positive scotoma. An average of 3.24 doses of intravitreal Avastin (IVA) were given to the patients. The mean best corrected visual acuity (BCVA) in log MAR value before IVA is 1.356 (SD =0.508). Improvement was found to be 1.262 (SD = 0.502) after first dose, 1.17 (SD = 0.542) after second dose and 1.084 (SD = 0.508) after third dose. The mean central foveal thickness (CFT) before IVA was 417 μm. After the first dose, the mean CFT reduced to 343 μm. Further reduction was observed after repeated injections (330.08 μm after second and 307.92 μm after third respectively). CONCLUSIONS There was significant increase in BCVA following intravitreal bevacizumab injection in wet AMD. More improvement was noted after repeated injections. There was a significant reduction in SRF and CFT in OCT after IVA injections. However, intra ocular pressure (IOP) was found to increase significantly after IVA.

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