Abstract
Background: Anti-vascular endothelial growth factors commonly used intravitreally for treatment of variable retinal disease worldwide, which help to regulate the upregulation of vascular endothelial growth factors due to ischemia or/and other retinal insult.
 Objective: To review all cases of intravitreal bevacizumab given in the retinal unit of the Eye Specialty Private Hospital in Iraq from December 2015 to June 2016, pointing out the common indications.
 Methods: A retrospective study including all cases of intravitreal injections of bevacizumab recorded at the Eye Specialty Private Hospital from December 2015 to June 2016 were retrieved. Age, sex, laterality, diagnosis and the indication for injection were recorded in the data sheet prepared for the study.. The indications for intravitreal injection of bevacizumab are classified into four groups: Group 1: Intravitreal injection for diabetic complications. Group 2: Intravitreal injection for retinal vein occlusion. Group 3: Intravitreal injection for choroidal neovascul-arization Group 4: Intravitreal injection for other retinal disease.
 Results: A total of 306 patients underwent intravitreal injection of bevacizumab were enrolled in the study period. The most common indication was group 1 (intravitreal injection for diabetic complications [213 patients (69.6%)] followed by group 3 (choroidal neovascularization) [45 patients (14.7%)] and then group 2 (intravitreal injection for retinal vein occlusion) [42 patients (13.7%)] and lastly group 4 (intravitreal injection for other retinal disease) represent [6 patients (1.96%)].
 Conclusion The most common indication for intravitreal bevacizumab was diabetic retino-pathy that need more care for early diagnosis and treatment of diabetic retinopathy and good screening programs to avoid complications.
Highlights
Vascular Endothelial Growth Factor (VEGF) is a homodimericglycoprotein which exists in four major isoforms (VEGF-121, -165, -189, -206)
VEGF is a pluripotent growth factor that functions as an endothelial cell-specific mitogen and vasopermeability factor and through these mechanisms the VEGF plays a critical role in promoting angiogenesis and vascular leakage (3), the active role of VEGF by disrupting the intercellular tight junctions between the retinal endothelial cells lead to increases in the extracellular accumulation of fluid from the intravascular compartment, as well as, VEGF shows a role in mediating active intraocular neovascularization (4)
The laterality of the injected eyes in study show that right eye was in 132 patients representing 43.14% while left eye was in 96 patients representing 31.37% while bilateral eye injected was in 78 patients representing 25.49% of patients
Summary
Vascular Endothelial Growth Factor (VEGF) is a homodimericglycoprotein which exists in four major isoforms (VEGF-121, -165, -189, -206). VEGF is a pluripotent growth factor that functions as an endothelial cell-specific mitogen and vasopermeability factor and through these mechanisms the VEGF plays a critical role in promoting angiogenesis and vascular leakage (3), the active role of VEGF by disrupting the intercellular tight junctions between the retinal endothelial cells lead to increases in the extracellular accumulation of fluid from the intravascular compartment, as well as, VEGF shows a role in mediating active intraocular neovascularization (4). Bevacizumab Bevacizumab is a full-length recombinant humanized monoclonal antibody with a molecular weight of 149 kDa (5). It binds to and inhibits all isoforms of vascular endothelial growth factor A (VEGF-A). The most growth factors commonly used intravitreally common indication was group 1 (intravitreal for treatment of variable retinal disease injection for diabetic complications [213 worldwide, which help to regulate the patients (69.6%)] followed by group 3 upregulation of vascular endothelial growth (choroidal neovascularization) [45 patients factors due to ischemia or/and other retinal (14.7%)] and group 2
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