Bevacizumab (Avastin) for the Treatment of Ocular Disease

ArticleinSurvey of Ophthalmology 54(3):372-400 · May 2009with22 Reads
DOI: 10.1016/j.survophthal.2009.02.004 · Source: PubMed
The use of intravitreal bevacizumab (Avastin) has greatly expanded since its introduction into ophthalmic care 3 years ago. A PubMed search on 1 August 2008 revealed 51 ocular disease processes that have been treated with bevacizumab. The majority of publications consist of case reports or retrospective case series and their number is increasing quickly. It is important to collate the experiences gained to date to properly inform our clinical decision making and improve the design of future clinical trials. Current studies cannot easily be combined in a meta-analysis given the lack of standardized data and the wide variety of disorders studied in small numbers. This paper will describe the attempted uses of intravitreal bevacizumab and its efficacy for each ocular disease in addition to discussing safety. Comments regarding appropriate use of this treatment are based on our current level of knowledge. It is clear that the initial encouraging results described in this paper warrant further study of intravitreal bevacizumab in larger, controlled, randomized trials.
    • "На данный момент показания бевацизумаба включают в себя применение при раке ободочной кишки, молочной, поджелудочной и предстательной железы . В связи с достаточно крупной молекулярной массой предполагалось, что эффективность его воздействия на сетчатку и хориоидею после интравитреальных инъекций может быть невысокой в связи с ограничением прохождения через слои сетчатки [25, 31, 51]. Ранибизумаб является фрагментом моноклонального антитела к фактору роста эндотелия сосудов со схожими с бевацизумабом свойствами, но меньшей молекулярной массой. "
    Article · Mar 2016
    • "Anti-VEGF agents have been utilized on an off-license basis for a vast array of other ocular pathologies ranging from external eye disease to ocular oncology and glaucoma. Indeed, a literature search in 2008 revealed 51 different ophthalmic diseases that had been treated with bevacizumab [67]. "
    [Show abstract] [Hide abstract] ABSTRACT: Ocular angiogenesis and macular oedema are major causes of sight loss across the world. Aberrant neovascularisation, which may arise secondary to numerous disease processes, can result in reduced vision as a result of oedema, haemorrhage, and scarring. The development of antivascular endothelial growth factor (anti-VEGF) agents has revolutionised the treatment of retinal vasogenic conditions. These drugs are now commonly employed for the treatment of a plethora of ocular pathologies including choroidal neovascularisation, diabetic macular oedema, and retinal vein occlusion to name a few. In this paper, we will explore the current use of anti-VEGF in a variety of retinal diseases and the impact that these medications have had on visual outcome for patients.
    Full-text · Article · Sep 2015
    • "Pegaptanib is an aptamer engineered to bind specifically to VEGF165, the isoform primarily responsible for pathological ocular angiogenesis (Ng et al., 2006). Bevacizumab is a humanized monoclonal antibody to VEGF inhibiting VEGF-receptor interaction (Gunther and Altaweel, 2009 ). Ranibizumab is a recombinant humanized fraction of anti-VEGF antibody that binds to all VEGF isoforms (Rosenfeld et al., 2006). "
    [Show abstract] [Hide abstract] ABSTRACT: Natural products are characterized by high chemical diversity and biochemical specificity; therefore, they are appealing as lead compounds for drug discovery. Given the importance of angiogenesis to many pathologies, numerous natural products have been explored as potential anti-angiogenic drugs. Ocular angiogenesis underlies blinding eye diseases such as retinopathy of prematurity (ROP) in children, proliferative diabetic retinopathy (DR) in adults of working age, and age-related macular degeneration (AMD) in the elderly. Despite the presence of effective therapy in many cases, these diseases are still a significant health burden. Anti-VEGF biologics are the standard of care, but may cause ocular or systemic side effects after intraocular administration and patients may be refractory. Many anti-angiogenic compounds inhibit tumor growth and metastasis alone or in combination therapy, but a more select subset of them has been tested in the context of ocular neovascular diseases. Here, we review the promise of natural products as anti-angiogenic agents, with a specific focus on retinal and choroidal neovascularization. The multifunctional curcumin and the chalcone isoliquiritigenin have demonstrated promising anti-angiogenic effects in mouse models of DR and choroidal neovascularization (CNV) respectively. The homoisoflavanone cremastranone and the flavonoid deguelin have been shown to inhibit ocular neovascularization in more than one disease model. The isoflavone genistein and the flavone apigenin on the other hand are showing potential in the prevention of retinal and choroidal angiogenesis with long-term administration. Many other products with anti-angiogenic potential in vitro such as the lactone withaferin A, the flavonol quercetin, and the stilbenoid combretastatin A4 are awaiting investigation in different ocular disease-relevant animal models. These natural products may serve as lead compounds for the design of more specific, efficacious, and affordable drugs with minimal side effects.
    Full-text · Article · Oct 2014
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