Predictors of Response After Intravitreal Bevacizumab Injection for Neovascular Age-Related Macular Degeneration

Purpose: To identify fluorescein angiography (FA) and optical coherence tomography (OCT) characteristics predicting responses to intravitreal bevacizumab therapy in patients with neovascular age-related macular degeneration (AMD). Methods: Results of 113 consecutive patients (113 eyes) treated with intravitreal bevacizumab injections for neovascular AMD were retrospectively reviewed. Patients were categorized into two groups according to visual acuity (VA) improvement 1 year after treatment: responders and nonresponders. Responders were defined as patients who achieved VA improvement >= 7 Early Treatment Diabetic Retinopathy Study (ETDRS) letters for occult choroidal neovascularization (CNV), and >= 11 ETDRS letters for classic CNV at month 12. Nonresponders were defined as patients who did not meet the above VA improvement at month 12. Results: Of the 113 eyes, 36 (31.9%) were categorized as responders and 77 (68.1%) as nonresponders. Nonresponders, compared with responders, had thicker subretinal tissue (SRT) (218.9 mu m versus 180.9 mu m, P = 0.040), and more frequent cystoid macular edema (CME) (42.9% versus 13.9%, P < 0.001). Conclusion: Thick SRT and CME on OCT may be characteristic of nonresponders and may be helpful for tailoring treatment for neovascular AMD. Jpn J Ophthalmol 2010;54:571-577 (C) Japanese Ophthalmological Society 2010