Anterior Chamber Flare During Bevacizumab Treatment in Eyes With Exudative Age-Related Macular Degeneration

In Brief Purpose: To study the anterior chamber flare during bevacizumab treatment of exudative age-related macular degeneration. Methods: During a 2-year prospective follow-up, 50 patients recently diagnosed with exudative age-related macular degeneration were treated at once-a-month visits if subretinal or intraretinal fluid or a new hemorrhage was present in the lesion area. Flare was measured weekly during the first month and then monthly in both eyes. Results: Higher flare was associated with older age (P = 0.007, Linear Mixed Model), higher number of smoking pack-years (P = 0.019), macular cysts (P = 0.041), and pseudophakia (P = 0.003). The levels gradually increased during the follow-up (P < 0.0001) but less in the eyes with classic CNV (P = 0.011). Flare decreased during treatment-free periods lasting for at least two consecutive visits (P = 0.005). A peak in flare was observed 1 week after the first injection (P = 0.034, Wilcoxon signed rank test). In the fellow eyes, higher flare values in the beginning of the follow-up were associated with later conversion into exudative age-related macular degeneration (P = 0.015, Mann–Whitney U test). Conclusion: Anterior chamber flare correlated poorly with the CNV activity. Higher levels may, however, precede or exist early in the process that leads to the development of exudative age-related macular degeneration. In a 2-year prospective follow-up of exudative age-related macular degeneration treated with bevacizumab, anterior chamber flare correlated with the area of classic CNV, presence of cystic macular fluid, and treatment-free periods. Otherwise, values associated poorly with the CNV activity. Fellow eyes developing exudative age-related macular degeneration later had higher flares early in the follow-up.