Effect Of Intravitreal Bevacizumab Research Articles

Intravitreal bevacizumab for surgical treatment of severe proliferative diabetic retinopathy

The purpose of this study is to evaluate the role, the safety and the effectiveness of intravitreal bevacizumab (IVB) injections as an adjunct to vitrectomy in the management of severe proliferative diabetic retinopathy (PDR). Case-Control Study Randomized controlled trial performed on 72 eyes of 68 patients affected by vitreous haemorrhage (VH) and tractional retinal detachment (TRD), which occurred as a consequence of active proliferative diabetic retinopathy (PDR). We randomly assigned eligible patients in a 1: 1: 1 ratio to receive a sham injection or an intravitreal injection of 1.25 mg of bevacizumab, either 7 or 20 days before the vitrectomy. In order to obtain three homogeneous groups of surgical complexity, we assigned to the following preoperative parameters a score from 0 to 3: a) vitreous haemorrhage, b) prior retinal laser-photocoagulation, c) morphological types of retinal detachment such as focal, hammock, central diffuse, table-top. Complete ophthalmic examinations and color fundus photography were performed at baseline and 1, 6, 12, and 24 weeks after the surgery. Intraoperative management, safety, efficacy of IVB at different time injection as an adjunct to vitrectomy in the management of severe PDR RESULTS: Group A (sham injection): intraoperative bleeding occurred in 19 cases (79.1%), the use of endodiathermy was necessary in 13 patients (54.1%), relaxing retinotomy was performed on one patient (4.1%), and in four cases (16.6%) iatrogenic retinal breaks occurred. The surgical mean time was 84 minutes (SD 12 minutes). Group B (bevacizumab administered 7 days before vitrectomy): intraoperative bleeding occurred in two cases (8.3%) and the use of endodiathermy was necessary in two patients (8.3%). No iatrogenic breaks occurred during the surgery. The surgical mean time was 65 minutes (SD 18 minutes). Group C (bevacizumab administered 20 days before vitrectomy): intraoperative bleeding occurred in three cases (12.5%), the use of endodiathermy was necessary in three patients (1.5%), and an iatrogenic break occurred in one patient (4.1%) while the delamination of fibrovascular tissue was being performed. The surgical mean time was 69 minutes (SD 21 minutes). The average difference in the surgical time was statistically significant between group A and group B (p = 0.025), and between group A and group C (p = 0.031). At the end of the surgery, the retina was completely attached in all eyes. At the 6-month follow-up, we observed the development of tractional retinal detachment (TRD) in one out of 24 patients from group C (4%). A preoperative intravitreal injection of bevacizumab may represent a new strategy for the surgical treatment of severe PDR by reducing retinal and iris neovascularization: this would make surgery much easier and safer, thus improving the anatomical and functional prognosis. According to our study, the best surgical results are achieved performing the IVB 7 days preoperatively.

Intravitreal Bevacizumab in Treatment of Idiopathic Persistent Central Serous Chorioretinopathy: A Prospective, Controlled Clinical Study

Purpose: To evaluate and determine the effect of intravitreal bevacizumab in treatment of persistent central serous chorioretinopathy.Methods: This prospective, comparative clinical study included 30 eyes of 30 patients with persistent, symptomatic central serous chorioretinopathy of 3 months’ duration or more. Fifteen eyes of 15 patients were treated with intravitreal injections of 2.5 mg (0.1 ml) bevacizumab (treatment group). Fifteen eyes of 15 patients with the same characteristics who declined treatment were an acceptable control group. The visual and anatomic responses were observed with best-corrected visual acuity and central foveal thickness measured by optic coherence tomography at baseline,1, 3, and 6 months after treatment.Results: Twelve (80%) eyes in the treatment group compared with 8 (53.3%) eyes in the control group showed morphologic restitution at 6 months (P < 0.01). All 15 (100%) treated eyes had stable or improved vision, compared with 10 (66.6%) eyes in the control group (P < 0.01). At 6 months, the mean ± SD central foveal thickness for the treatment group remained significantly lower compared to the control group, with 174 ± 68 µm and 297 ± 172 µm, respectively (P < 0.001). Injection-related complications were not encountered.Conclusions: Our results indicate that intravitreal bevacizumab injection may be a new, promising treatment option for select patients with idiopathic persistent central serous chorioretinopathy. Continued studies with intravitreal bevacizumab in this population will help to establish its long-term efficacy.

The Short-term Effect of Intravitreal Bevacizumab for Treatment of Central Serous Chorioretinopathy

Purpose: To determine whether intravitreal bevacizumab is effective for the treatment of central serous chorioretinopathy. Methods: We retrospectively examined 42 eyes after intravitreal bevacizumab (1.25 mg) injection for central serous chorioretinopathy. After 1 month, improvement of vision and change in sensory retinal detachment were evaluated with a fundus examination and optical coherence tomography. Results: The mean duration of symptoms was 3.92.31 months. After intravitreal bevacizumab injection, mean best corrected visual acuity improved from 0.530.31 to 0.720.29 at 1 month. In addition, neurosensory retinal detachment disappeared in 32 patients (76.2%). Five patients among ten who did not show improvement of neurosensory retinal detachment underwent reinjection of bevaczumab, and three of those reinjected showed the resolution of neurosensory retinal detachment at another 1 month. No improvement was seen among the patients who did not undergo reinjection. Conclusions: Intravitreal bevacizumab injection appears to have a short-term benefit for the treatment of central serous chorioretinopathy.

Effect of Intravitreal Bevacizumab (Avastin) on the Growing Rabbit Eye

Purpose: To study the effect of intravitreal bevacizumab (Avastin®) on the structure and growth of the young rabbit eye. Materials and Methods: Twelve 6-week-old rabbits underwent intravitreal injection of bevacizumab (1.25 mg/0.05 ml) in one eye and no injection in the other (study group). Six additional rabbits served as controls. Slit lamp examination, fundus evaluation, and measurements of corneal power, central corneal thickness, corneal astigmatism, and axial length were performed before treatment and 1, 2, and 3 months after. At 3 months, the rabbits were sacrificed for histological study. Results: Within the study group, there were no significant differences in clinical parameters between the bevacizumab-treated and fellow eyes at any timepoint or overall. The estimated confidence intervals extended to about one standard deviation of their respective values. Comparison of the injected eyes in the study group with the uninjected eyes in the control group yielded similar findings. There were no between-group differences in ocular growth and no abnormalities of the anterior and posterior segments or the retina and retinal vasculature. Conclusions: Intravitreal bevacizumab apparently has no adverse effect on the growth and development of the young rabbit eye, in a biologically or statistically significant way.

Short-term Efficacy of Intravitreal Bavacizumab for Polypoidal Choroidal Vasculopathy

Purpose: To evaluate the short-term effect of intravitreal bevacizumab (Avastin) in polypoidal choroidal vasculopathy. Methods: Intravitreal Avastin was injected into 13 eyes of 13 patients with PCV in this retrospective, interventional case study. The follow-up period lasted over 3 months after therapy. Changes in best-corrected visual acuity (BCVA), foveal height determined by optical coherence tomography, and abnormal vasculature in indocyanine green angiography (ICGA) were evaluated. Results: The mean LogMAR BCVA was 0.82 at baseline, 0.78 at 1 month after treatment, and 0.73 at 3 months after treatment. Visual acuity was stabilized or improved in 13 eyes (100%). The mean foveal height was 288 at baseline, 231 (p at 3 months after treatment. The polypoidal lesions in ICGA decreased in 4 eyes (31%), although branching vasculature in ICGA was unchanged in 13 eyes (100%). Conclusions: Intravitreal injection of Avastin may stabilize visual acuity and reduce macular edema due to decreased retinal pigment epithelial detachment and leaking. However, intravitreal injection had a minimal effect in occlusion of the symptomatic polypoidal lesions and no effect in occlusion of the branching vascular network.

Long-term Effect of Intravitreal Bevacizumab for CNV Secondary to Age-Related Macular Degeneration

Purpose: To investigate the long-term therapeutic effect and safety of repeated intravitreal bevacizumab injections for managing choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD). Methods: Clinical data of 14 eyes of 14 patients who were treated with repeated (3 times or more) intravitreal bevacizumab injections for secondary to AMD and followed up for 12 months were collected. Patients were treated with 1.25 mg of intravitreal bevacizumab. Bevacizumab was injected at 6-week intervals. Reinjection was performed with the same method according to the physician’s decision. Results: Mean visual acuity change increased by 4.0 lines from 1.13±0.47 to 0.73±0.44 (LogMAR). Mean central retinal thickness change decreased by 114.8 µm from 240.3±123.8 µm to 125.5±39.4 µm. Visual acuity improved statistically significantly at 12 weeks after first intravitreal bevacizumab injections and was maintained for 12 months. Central retinal thickness decreased statistically significantly at 6 weeks after the first intravitreal bevacizumab injection and was maintained for 12 months. During the 12 months of 4 intravitreal bevacizumab injections, mean visual acuity change increased by 4.0 lines at 12 months and 4.4 lines at 7 months. Conclusions: Intravitreal bevacizumab injection causes a significant decrease in central retinal thickness and improvement in visual acuity in eyes with CNV due to AMD for 12 months.

Role of Intravitreal Bevacizumab in Neovascular Glaucoma

We report on the effect of intravitreal bevacizumab (IVB) for the treatment of neovascular glaucoma (NVG). A retrospective chart review of 6 consecutive cases of NVG was performed. The follow-up period was 3-19 months (average, 9.7 months). All patients received 1.25 mg (0.05 cc) of IVB followed by panretinal photocoagulation (PRP) approximately 1 week later. In all cases, there was a complete regression of iris and anterior chamber angle neovascularization. However, 2 eyes showed a recurrence of neovascularization; in 1 case, it recurred after 3 months, and in the second, after 5 months. These patients received another IVB injection followed by additional PRP, which resulted in the resolution of the recurrent neovascularization. Glaucoma was controlled with topical eye drops alone in patients who had iris and angle neovascularization without peripheral anterior synechiae (PAS). However, patients with PAS at the time of presentation needed subsequent glaucoma surgery. Our study suggests that IVB may be a valuable addition in the treatment of NVG by hastening the resolution of anterior segment neovascularization, improving the results of glaucoma surgeries, and appears to give long-term control when used in combination with PRP.