Article

Dose of intravitreal bevacizumab (Avastin) used as preoperative adjunct therapy for proliferative diabetic retinopathy.

Department of Ophthalmology, School of Medicine, Nihon University, Kanda, Chiyodaku, Tokyo, Japan.
Retina (Philadelphia, Pa.) (impact factor: 2.93). 05/2010; 30(5):761-4. DOI:10.1097/IAE.0b013e3181c70168 pp.761-4
Source: PubMed

ABSTRACT The purpose of this study was to examine the effect of lower than usual doses of intravitreal bevacizumab (Avastin) on vitreous vascular endothelial growth factor (VEGF) concentration and intraoperative bleeding when used as preoperative adjunct therapy in patients undergoing vitrectomy for proliferative diabetic retinopathy.
Fifty-two eyes (52 patients) with indications for vitrectomy were studied; 12 received bevacizumab, and 40 did not. The bevacizumab group was given a single intravitreal injection of bevacizumab (0.16-1.25 mg) 3 days before vitrectomy. Numbers of intraoperative coagulation spots administered for hemostasis were compared between the two groups. In both groups, vitreous samples were collected during vitrectomy, and VEGF levels were measured by enzyme-linked immunosorbent assay.
The VEGF concentration was 1880.1 +/- 1927.5 in the nonbevacizumab group and 24.9 +/- 25.1 in the bevacizumab group, and the difference was significant (P = 0.0001). Although VEGF concentrations were apparently lower at higher bevacizumab doses, no significant correlation was observed (r = 0.366, P = 0.2425). Numbers of intraoperative coagulation spots differed significantly between the bevacizumab (3.2 +/- 0.8) and nonbevacizumab (5.7 +/- 1.0) groups (P < 0.0001). In the bevacizumab group, there was no correlation between the number of intraoperative coagulation spots and the bevacizumab dose (r = 0.272, P = 0.3919).
When intravitreal bevacizumab was administered as preoperative adjunct therapy to patients undergoing vitrectomy for proliferative diabetic retinopathy, the lowest dose tested (0.16 mg) was as effective as the standard dose (1.25 mg) in reducing vitreous VEGF concentrations and also decreasing intraoperative bleeding as measured by the reduced number of coagulation spots.

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Keywords

bevacizumab dose
 
bevacizumab group
 
coagulation spots
 
decreasing intraoperative
 
enzyme-linked immunosorbent assay
 
higher bevacizumab doses
 
intraoperative coagulation spots
 
intravitreal bevacizumab
 
lowest dose
 
nonbevacizumab group
 
patients undergoing vitrectomy
 
preoperative adjunct therapy
 
proliferative diabetic retinopathy
 
significant correlation
 
single intravitreal injection
 
standard dose
 
two groups
 
VEGF concentrations
 
vitreous vascular endothelial growth factor
 
vitreous VEGF concentrations