Systemic anti-VEGF biosimilar therapy associated with improved macular anatomy and duration of effect in a patient with nearly recalcitrant neovascular age-related macular degeneration

Abstract

To present a patient with neovascular AMD treated systemically with the biosimilar bevacizumab-awwb (Mvasi) with superior SRF resolution when compared to continuous and repeated intravitreal treatments. Retrospective single case report. After 3 years of monthly aflibercept treatment for nAMD, the patient had persistent subretinal fluid (SRF). Systemic bevacizumab-awwb (Mvasi) infusions were initiated by her oncologist for ovarian cancer and SRF resolved for the first time. After one additional aflibercept injection, and continued bevacizubam-awwb infusions for her cancer, SRF did not recur. Thirteen weeks later, at final follow-up before the patient passed away, the macula remained dry and no additonal intravitreal treatment was given. When systemic anti-VEGF biosimilar therapy was administered, there was improved anatomy and prolonged duration of effect compared to the intravitreal therapy alone. Adverse systemic effects limit the routine use of systemic anti-VEGF therapy for retinal disease. However if a patient requires systemic anti-VEGF or anti-VEGF biosimilar therapy for malignancy, it may also benefit retinal disease leading to benefits in quality of life and fewer office visits.