Intravitreal bevacizumab (Avastin) for post laser anterior segment ischemia in aggressive posterior retinopathy of prematurity

Vitreo-Retinal Services, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India.
Indian Journal of Ophthalmology (Impact Factor: 0.9). 03/2007; 55(1):75-6. DOI: 10.4103/0301-4738.29505
Source: PubMed


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.

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    • "However, recently, there have been many case reports stating the efficacy of intracameral or intravitreal bevacizumab (Avastin, Genentech, Inc, San Francisco, CA) a recombinant, humanized anti-vascular endothelial growth factor (VEGF) antibody in the treatment of NVG due to other vascular disorders. It has been reported to cause rapid regression of rubeosis with a single application.[9–11] It has also been reported to improve success rate by maintaining well-functioning bleb resulting in better stabilization of IOP.[1213] Bevacizumab is now being looked at as a promising adjunct for the treatment of NVG. "
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    ABSTRACT: We report two cases of intraocular cysticercosis which showed a peculiar presentation of neovascular glaucoma which is hitherto unreported. Two young adults presented with symptoms of raised intraocular pressure due to neovascular glaucoma. On dilated fundus examination both were found to have dead intravitreal cysticercosis. The cysts were removed by a three-port vitrectomy and intracameral injection of bevacizumab was given to help in the regression of rubeosis. Trabeculectomy had to be combined in one case. The intraocular pressure returned to normal. No recurrence of rubeosis was seen even after one year.
    Indian Journal of Ophthalmology 04/2010; 58(1):70-3. DOI:10.4103/0301-4738.58478 · 0.90 Impact Factor
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    • "Two patients with pseudophakic cystoid macular edema refractory to conventional medical treatment received IVB which resulted in a marked VA improvement in both cases (Mason et al 2006). IVB also caused regression of iris, retinal, and choroidal neovascularization in a case of anterior segment ischemia caused by laser ablation for aggressive posterior retinopathy of prematurity (Shah et al 2007). IVB was attempted in 6 patients with chronic macular edema due to uveitis but, although well tolerated, none of the patients had significant improvement in either visual acuity or central retinal thickness after 1 month (Ziemssen et al 2007). "
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    ABSTRACT: To review the English language publications addressing the effect of intravitreal bevacizumab (IVB) injection in a variety of eye conditions and analyze the data where possible. Examination of data obtained using a Pubmed literature search conducted mid May 2007 with the keywords "intravitreal bevacizumab". A dose of 1.25 mg was used in 89.5% of 965 age-related macular degeneration (ARMD) cases with 47% receiving intravitreal bevacizumab as primary therapy. In 829 patients receiving repeated doses of 1.25 mg the mean logMAR best-corrected visual acuity (BCVA) improved from 0.88 at baseline to 0.74 at 4-6 weeks, 0.71 at 8-10 weeks, 0.67 at 12-14 weeks and 0.86 at >14 weeks. Mean central retinal thickness (CRT) decreased by 83.71 mum at 4-6 weeks, 79.52 mum at 8-10 weeks, 92.46 mum at 12-14 weeks, and 75.64 mum at >14 weeks respectively. In 64 patients receiving IVB for retinal vein occlusion (RVO) mean logMAR BCVA decreased from 1.21 at baseline to 0.83 and 0.82 at 4 and 12 weeks respectively. Mean CRT decreased from 635.97 mum at baseline to 320.06 mum and 346.27 mum at 4 and 12 weeks. Favorable responses have been reported in various other conditions. Current evidence suggests that intravitreal bevacizumab, alone or as an adjunct to conventional therapy, has a beneficial effect in various neovascular and edematous retinal conditions and is well tolerated in the short term.
    Clinical ophthalmology (Auckland, N.Z.) 10/2007; 1(3):273-84.
    • "Anecdotal report does suggest beneficial effect and clinical trial results are awaited.43 Intravitreal bevacizumab has also been used in the treatment of aggressive posterior retinopathy of prematurity.52 Anecdotal reports also show the effect of intravitreal bevacizumab in the treatment of central retinal vein occlusion, branch retinal vein occlusion53,54 and neovascular glaucoma.55 "
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    ABSTRACT: In the last few years anti-vascular endothelial growth factor (VEGF) therapy has changed the paradigm in the treatment of neovascular age-related macular degeneration (ARMD). Besides, its potential use in the treatment of diabetic retinopathy and other possible proliferative vascular disorders has also shown promise. Clinical trial results have shown tremendous beneficial effect of ranibizumab in ARMD. Off-label use of bevacizumab has also shown similar benefit but long-term and clinical trial results do not exist. Some of the potential questions in the use of anti-VEGF are recurring cost, possible long-term effect on physiological function of VEGF and determination of endpoint of treatment. Overall, the use of anti-VEGF therapy in ocular angiogenesis has proven to be beneficial at least now.
    Indian Journal of Ophthalmology 03/2007; 55(6):445-50. DOI:10.4103/0301-4738.36480 · 0.90 Impact Factor
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