Intravitreal bevacizumab (Avastin) for post laser anterior segment ischemia in aggressive posterior retinopathy of prematurity.
ABSTRACT Aggressive posterior retinopathy of prematurity (formerly known as fulminate/type II/rush disease) occurs in zone 1 or posterior zone 2. Treatment involves extensive near confluent laser ablation of a large area of avascular retina. Anterior segment ischemia is a rare complication that can occur due to injury to the long posterior ciliary arteries in the horizontal meridians during aggressive posterior laser treatment. The outcome of this rare complication is very poor. This case describes a favorable outcome of intravitreal injection of bevacizumab (Avastin) in a case of anterior segment ischemia.
Article: Bevacizumab for ophthalmic diseases[Show abstract] [Hide abstract]
ABSTRACT: Bevacizumab, a humanized monoclonal antibody that binds to all isoforms of vascular endothelial growth factor, was originally developed to inhibit tumor angiogenesis. Following its approval for the treatment of metastatic colorectal cancer, bevacizumab was initially used systemically in patients with neovascular age-related macular degeneration. Two case reports on intravitreal bevacizumab led to numerous clinical and preclinical studies on bevacizumab. Intravitreal bevacizumab is popular worldwide as an inexpensive off-label treatment for several neovascular ocular diseases. This article reviews the current clinical and preclinical studies using bevacizumab in ophthalmology.Expert Review of Ophthalmology 01/2014; 2(3). DOI:10.1586/17469818.104.22.1689
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ABSTRACT: Purpose: To compare the structural outcome at 9 months of eyes treated with intravitreal injection of bevacizumab with fellow eyes treated with conventional laser photoablation in zone I type 1 retinopathy of prematurity (ROP). Design: Single randomized controlled trial. Participants: All inborn babies with type 1 zone I ROP at a single institution were included in the study. One eye was randomized to receive an intravitreal injection of 0.5 mg bevacizumab; the fellow eye received conventional laser photoablation. Methods: Digital fundus photographs and fluorescein angiography (FA) using the RetCam (Clarity Medical Systems Inc., Pleasanton, CA) were performed before treatment and 9 months after treatment. Main Outcome Measures: Presence of retinal and choroidal abnormalities on FA at 9 months. Results: Thirteen infants were enrolled; 1 died 3 months after birth. One laser-treated eye progressed to stage 5 retinal detachment. The remaining 23 eyes had favorable structural results at the 9-month follow-up and provided FA results. At 9 months of age, all eyes treated with a bevacizumab injection were noted to have abnormalities at the periphery (large avascular area, abnormal branching, shunt) or the posterior pole (hyperfluorescent lesion, absence of foveal avascular zone). These posterior and peripheral lesions were not observed in the majority of the lasered eyes. Conclusions: This study documents significant vascular and macular abnormalities of eyes in the bevacizumab group. Long-lasting implications of these abnormalities for visual function of the child need to be studied. (C) 2014 by the American Academy of Ophthalmology.Ophthalmology 07/2014; 121(11). DOI:10.1016/j.ophtha.2014.05.015 · 6.17 Impact Factor
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ABSTRACT: Retinopathy of prematurity (ROP) remains an important cause of childhood blindness. Improved survival of premature infants has led to more infants being at risk of developing ROP. Advances in basic and clinical research have identified additional risk factors for ROP beyond gestational age, birth weight, and supplemental oxygen. Greater understanding of the pathophysiology of ROP and the risk factors involved will allow more targeted therapeutic approaches.12/2013; 1(4):213-217. DOI:10.1007/s40135-013-0028-y