Rosenfeld PJ, Fung AE, Puliafito CA. Optical coherence tomography findings after an intravitreal injection of bevacizumab (Avastin) for macular edema from central retinal vein occlusion

Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami School of Medicine, Miami, Florida, USA.
Ophthalmic Surgery Lasers and Imaging (Impact Factor: 1.32). 07/2005; 36(4):336-9.
Source: PubMed

ABSTRACT To determine whether bevacizumab could improve visual acuity and optical coherence tomography outcomes in a patient with macular edema from central retinal vein occlusion, an intravitreal injection of bevacizumab (1.0 mg) was given. Prior intravitreal injections of triamcinolone acetonide resulted in vision improvement but worsening cataract and borderline glaucoma. Within 1 week of the bevacizumab injection, visual acuity improved from 20/200 to 20/50 and optical coherence tomography revealed resolution of the cystic maculopathy. The improvements were maintained for at least 4 weeks. Intravitreal injections of bevacizumab may provide another treatment option for patients with macular edema from vein occlusions.

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    • "Since the first report on the efficacy of intravitreal bevacizumab (IVB) in a patient with ME secondary to CRVO in 2005 [8], a number of case series have shown that it has promising effects, with rapid reduction in foveal thickness and improvement in VA [9] [10] [11] [12]. However, the main limitations of this treatment are its short-term effects and a high reported rate of ME recurrence [8] [13]. Some formats of retreatment were previously described not only in the era of BRVOS study [5] but also in the recent BRAVO study [14]. "
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    ABSTRACT: Background. To evaluate the efficacy of intravitreal bevacizumab (IVB) injection with or without macular laser photocoagulation (MLP) for recurrent or persistent macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Methods. Thirty-four eyes underwent IVB injection for ME secondary to BRVO as a primary treatment. Twenty of the 34 eyes experienced recurrent or persistent ME after the first IVB. Nine of the 20 eyes (Group 1) were retreated with IVB combined with MLP. The remaining 11 eyes (Group 2) were retreated with IVB alone. Results. In Group 1, the postoperative best corrected visual acuity (BCVA) improved compared with the preoperative value at all follow-up visits, although no statistically significant improvement was observed at 6 months. In contrast, BCVA significantly improved from 0.53 to 0.40 at 6 months (P < 0.05) in Group 2. Conclusion. Combined therapy tended to have a smaller effect on visual acuity compared with IVB monotherapy.
    Journal of Ophthalmology 07/2014; 2014:173084. DOI:10.1155/2014/173084 · 1.94 Impact Factor
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    • "Bevacizumab (Avastin, Genentech, Inc., San Francisco, California, USA) is a full-length humanized monoclonal nonselective antibody against vascular endothelial growth factor approved by the Food and Drug Administration for the treatment of glioblastoma and of metastatic colorectal cancer, advanced nonsquamous non-small-cell lung cancer and metastatic kidney cancer in combination with chemotherapy. Rosenfeld et al. described for the first time the use of intravitreal bevacizumab (IVB) for the treatment of macular oedema secondary to retinal vein occlusion and exudative age-related macular degeneration [35] [36]. Since then, several studies have described the off-label use of IVB for the treatment of numerous vascular and oedematous eye diseases. "
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    ABSTRACT: Sterile endophthalmitis appears as an infrequent complication of intravitreal injections and seems to develop mainly in the context of the off-label use of drugs that have not been conceived for intravitreous administration. The aetiology of sterile endophthalmitis, independently of the administered drug, remains uncertain and a multifactorial origin cannot be discarded. Sterile inflammation secondary both to intravitreal triamcinolone acetonide and to intravitreal bevacizumab share many characteristics such as the acute and painless vision loss present in the big majority of the cases. Dense vitreous opacity is a common factor, while anterior segment inflammation appears to be mild to moderate. In eyes with sterile endophthalmitis, visual acuity improves progressively as the intraocular inflammation reduces without any specific treatment. If by any chance the ophthalmologist is not convinced by the sterile origin of the inflammation, this complication must be treated as an acute endophthalmitis because of the devastating visual prognosis of this intraocular infection in the absence of therapy.
    Mediators of Inflammation 08/2012; 2012:928123. DOI:10.1155/2012/928123 · 3.24 Impact Factor
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    • "Previous groups have evaluated the safety of intravitreal injection of bevacizumab in rabbits using electrophysiological testing [15] and histopathological analysis [3]. Recently, several studies have reported beneficial therapeutic effects of intravitreal injection of bevacizumab as well as documenting its penetration into the deeper retinal layers [2] [7] [9]. "
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    ABSTRACT: To analyze the retinal toxicity of bevacizumab at various doses both in vitrectomized and non-vitrectomized rabbit models. Twenty- eight rabbits were included in the study. Twenty- four rabbits were assigned to six groups, with 4 of the rabbits in the control group. The animals in Groups 1, 2 and 3 received bevacizumab at a dose of 0.3 mg, 0.5 mg and 1.5 mg /eye, respectively. The rabbits in Groups 4, 5 and 6 received intravitreal bevacizumab of 0.3 mg, 0.5 mg and 1.5mg/eye, respectively, after gas compression vitrectomy. Two weeks after the procedure, the rabbits were euthanized. Retina tissue samples were then obtained and examined with both light and electron microscopes. In Groups 1, 2 and 3 after bevacizumab injection, toxic degeneration in the photoreceptor and retinal pigment epithelium cells was observed via electron microscopic examination. The findings in Groups 4 and 5 were normal as compared to the control group. In Group 6, toxicity in the bipolar neurons and photoreceptor cells was noticed. Increased toxicity and retinal penetration were noticed in all administered doses of bevacizumab in the presence of vitreous. In addition, ocular toxicity occurred through the injection of the highest dose of bevacizumab after vitrectomy. It is possible that the bevacizumab dose and the, vitreous are as important as the drug half-life in the vitreous. KeywordsAnti-VEGF-Bevacizumab-Electron microscopy
    Central European Journal of Medicine 12/2009; 5(6):745-751. DOI:10.2478/s11536-009-0120-8 · 0.21 Impact Factor
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