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


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 · 1.43 Impact Factor
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    • "Avastin is commercially available as a 100 mg or 400 mg vial containing 25 mg/ml bevacizumab. The recommended intravitreal dose of bevacizumab is 1 to 1.25 mg (0.04 to 0.05 ml) of the commercially available Avastin.[1516] This injected drug is presumed to diffuse uniformly into the entire vitreous. "
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    ABSTRACT: Purpose: To evaluate the effect of bevacizumab on the mitochondrial function of human retinal pigment epithelial (ARPE-19), rat neurosensory retinal (R28) and human microvascular endothelial (HMVEC) cells in culture. Materials and Methods: ARPE-19 and R28 cells were treated with 0.125, 0.25, 0.50 and 1 mg/ml of bevacizumab. The HMVEC cultures were treated with 0.125, 0.25, 0.50 and 1 mg/ml of bevacizumab or 1 mg/ml of immunoglobulin G (control). Mitochondrial function assessed by mitochondrial dehydrogenase activity (MDA) was determined using the WST-1 assay. Results: Bevacizumab doses of 0.125 to 1 mg/ml for 5 days did not significantly affect the MDA of ARPE-19 cells. Bevacizumab treatment at 0.125 and 0.25 mg/ml (clinical dose) did not significantly affect the MDA of R28 cells; however, 0.50 and 1 mg/ml doses significantly reduced the R28 cell mitochondrial function. All doses of bevacizumab significantly reduced the MDA of proliferating and non-proliferating HMVEC. Conclusion: Bevacizumab exposure for 5 days was safe at clinical doses in both ARPE-19 and R28 retinal neurosensory cells in culture. By contrast, bevacizumab exposure at all doses show a significant dose-dependent decrease in mitochondrial activity in both the proliferating and non-proliferating HMVEC in vitro. This suggests a selective action of bevacizumab on endothelial cells at clinical doses.
    Indian Journal of Ophthalmology 12/2013; 61(12):705-10. DOI:10.4103/0301-4738.124750 · 0.90 Impact Factor
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    • "Pharmacotherapy utilizing intravitreal injections of antivascular endothelial growth factor (anti-VEGF) agents has revolutionized the treatment of neovascular retinal disorders by inhibiting angiogenesis. Bevacizumab was the first intravitreal agent utilized for the treatment of macular edema secondary to a branch retinal vein occlusion and age-related macular degeneration [2, 3]. Today, multiple anti-VEGF agents have been developed including bevacizumab, pegaptanib, ranibizumab, and aflibercept. "
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    ABSTRACT: Vascular endothelial growth factor (VEGF) is a potent promoter of angiogenesis involved in a wide variety of physiologic processes. Intravitreal injections targeting VEGF have transformed the treatment of neovascular retinal diseases. Currently, there are four anti-VEGF agents in use: bevacizumab, ranibizumab, pegaptanib, and aflibercept. The success and frequency of anti-VEGF therapy have made the ocular safety profile of these agents of vital importance. This paper focuses on sterile endophthalmitis. In this paper, we compare the incidences of posttreatment sterile endophthalmitis among the four agents, review the mechanism of actions, and discuss the most prevalent hypotheses leading to sterile endophthalmitis.
    Mediators of Inflammation 11/2013; 2013(4):943409. DOI:10.1155/2013/943409 · 3.24 Impact Factor
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