Bevacizumab Injection In Patients Research Articles

Comparison of eGFR Levels in Patients Before and After Intravitreal Bevacizumab (Anti-VEGF) Injection

Background: Estimated glomerular filtration rate (eGFR) is a vital indicator of kidney function, particularly in patients receiving treatments that may impact renal health, such as intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections like bevacizumab. Bevacizumab, commonly used to treat retinal diseases like diabetic retinopathy, has raised concerns about its potential systemic effects, including its impact on kidney function due to the role of VEGF in maintaining glomerular integrity. This study investigates the effect of bevacizumab injections on renal function in patients with diabetic kidney disease (DKD) and those without. Objective: To assess changes in eGFR before and after intravitreal bevacizumab injections in patients with and without diabetic kidney disease, evaluating whether these injections significantly affect renal function. Methodology: This quasi-experimental study was conducted in the Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University (BSMMU), from April 2019 to August 2021. Forty patients with diabetic retinopathy were selected, divided equally into DKD and non-DKD groups. Serum creatinine and eGFR were measured within 30 days before the injection and one month after the third dose of intravitreal bevacizumab. eGFR was calculated using the CKD-EPI equation, and statistical analysis was performed using SPSS. Results: The mean pre-injection eGFR was 69.35±25.91 ml/min/1.73m² in the DKD group and 96.7±30.59 ml/min/1.73m² in the non-DKD group. Post-injection, the mean eGFR was 73.3±33.87 ml/min/1.73m² in DKD patients and 93.6±29.7 ml/min/1.73m² in non-DKD patients. The mean differences in eGFR were not statistically significant between pre- and post-injection measurements in either group (p>0.05). Conclusion: Intravitreal bevacizumab injections did not cause significant changes in eGFR in both DKD and non-DKD patients, suggesting that the treatment is unlikely to have a detrimental impact on renal function in the short term. Further studies are needed to assess the long-term effects of repeated injections.

The Predictors of Early Treatment Effectiveness of Intravitreal Bevacizumab Application in Patients with Diabetic Macular Edema.

The aim of this study was to establish whether multiple blood parameters might predict an early treatment response to intravitreal bevacizumab injections in patients with diabetic macular edema (DME). Seventy-eight patients with non-proliferative diabetic retinopathy (NPDR) and DME were included. The treatment response was evaluated with central macular thickness decrease and best corrected visual acuity increase one month after the last bevacizumab injection. Parameters of interest were the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), vitamin D, and apolipoprotein B to A-I ratio (ApoB/ApoA-I). The NLR (2.03 ± 0.70 vs. 2.80 ± 1.08; p < 0.001), MLR (0.23 ± 0.06 vs. 0.28 ± 0.10; p = 0.011), PLR (107.4 ± 37.3 vs. 135.8 ± 58.0; p = 0.013), and SII (445.3 ± 166.3 vs. 675.3 ± 334.0; p < 0.001) were significantly different between responder and non-responder groups. Receiver operator characteristics analysis showed the NLR (AUC 0.778; 95% CI 0.669-0.864), PLR (AUC 0.628; 95% CI 0.511-0.735), MLR (AUC 0.653; 95% CI 0.536-0.757), and SII (AUC 0.709; 95% CI 0.595-0.806) could be predictors of response to bevacizumab in patients with DME and NPDR. Patients with severe NPDR had a significantly higher ApoB/ApoA-I ratio (0.70 (0.57-0.87) vs. 0.61 (0.49-0.72), p = 0.049) and lower vitamin D (52.45 (43.10-70.60) ng/mL vs. 40.05 (25.95-55.30) ng/mL, p = 0.025). Alterations in the NLR, PLR, MLR, and SII seem to provide prognostic information regarding the response to bevacizumab in patients with DME, whilst vitamin D deficiency and the ApoB/ApoA-I ratio could contribute to better staging.

Changes in aqueous concentrations of various cytokines after intravitreal bevacizumab injection for chronic central serous chorioretinopathy.

This study aimed to investigate changes in cytokine levels after intravitreal bevacizumab injection in patients with chronic central serous chorioretinopathy (CSC). In a prospective interventional trial, 12 eyes of 12 patients with chronic CSC and 6 eyes of 6 patients who underwent cataract surgery were included as controls. Patients diagnosed as with CSC received a single intravitreal injection of bevacizumab (1.25 mg/0.05 mL). Aqueous humor samples were collected from the patients and controls. Best-corrected visual acuity and foveal thickness were evaluated, and aqueous samples were obtained before and 4 weeks after injection. The aqueous concentrations of interleukin (IL)-6, IL-8, interferon-induced protein (IP)-10, monocyte chemotactic protein (MCP)-1, platelet-derived growth factor (PDGF)-AA, and vascular endothelial growth factor (VEGF) were measured using a multiplex bead assay. After injection, the foveal thickness decreased significantly from 328 (210-477) to 283 (168-356) (p = 0.048), but the best-corrected visual acuity was not significantly different (p = 0.066). The aqueous levels of IL-8 increased significantly from 3.3 pg/mL (1.5-8.3) to 4.7 pg ⁄ mL (2.2-11.6) at 4 weeks after the injection (p = 0.046). The aqueous levels of VEGF decreased significantly from 31.4 pg/mL (17.0-53.3) to 15.2 pg/mL (7.7-21.5) (p < 0.01). No significant changes in IL-6, IP-10, MCP-1, and PDGF-AA levels were noted 4 weeks after injection (p = 0.455, p = 0.055, p = 0.076, and p = 0.339, respectively). In this study we found intravitreal bevacizumab injection decreased VEGF and increased IL-8 in the eyes of patients with chronic CSC. This study suggests the possibility that the pathogenesis of CSC may be related to abnormal circulation of the choroidal blood vessels through VEGF and IL-8 cytokine level changes.

Mean Best Corrected Visual Acuity after Intravitreal Bevacizumab in Patients with Diabetic Macular Edema

Purpose: To determine mean best corrected visual acuity after intravitreal bevacizumab in patients with diabetic macular edema. Study Design: Quasi experimental study. Place and Duration of Study: Jinnah Hospital, Lahore and Chaudary Muhammad Akram Hospital Lahore from March 2018 to May 2021. Methods: A total of 200 patients of either gender with diabetic macular edema and age between 40 and 60 years were included in this study. Patients with dense cataract, corneal opacity, uncontrolled diabetes mellitus and those who were treated with pan retinal photocoagulation were excluded. Best corrected Visual Acuity (BCVA) was evaluated with Snellen chart and converted to log MAR. A standard protocol of 0.05 mL of Bevacizumab was prepared from injection Avastin, 100 mg/4 mL vial. Bevacizumab injection was given to all patients, using topical anesthesia, under aseptic measures in the operation theater. A total of 03 injections were given at 1-month interval. After three months, BCVA was recorded. Results were presented in number and percentages. Results: Mean age of the participants was 50.42 ± 6.48 years. Male to female ratio was 1:1.6, with 78 (39.0%) men and 122 (61.0%) women. Mean duration of diabetes mellitus was 5.12 ± 2.23 years. Mean pre-treatment BCVA was 0.51 ± 0.05 and mean post-treatment BCVA at three months was 0.26 ± 0.22. Conclusion: Mean BCVA is increased after intravitreal injection of Bevacizumab in patients with diabetic macular edema.

Successful regression of newly formed corneal neovascularization by subconjunctival injection of bevacizumab in patients with chemical burns.

To investigate the effect and timing of subconjunctival bevacizumab injection on inhibiting corneal neovascularization (CorNV) in patients after chemical burns. Patients with CorNV secondary to chemical burns were involved. Two subconjunctival injections of bevacizumab (2.5 mg/0.1 mL per involved quadrant) with an interval of 4 weeks were administered, and followed up a year. The area occupied by neovascular vessels (NA), accumulative neovascular length (NL), mean neovascular diameter (ND), best-corrected visual acuity (BCVA) and intraocular pressure (IOP) were evaluated. Complication was also recorded. Eleven patients with CorNV were involved. Eight patients had a history of surgery (four had amniotic grafts, one had keratoplasty, and three had amniotic grafts and keratoplasty). Decreasing in NA, NL, and ND were statistically significant at each time point compared to the baseline (p < 0.01). CorNV that developed within 1 month was considerably regressed, and vessels with fibrovascular membranes were found to be narrower and shorter than pretreatment. BCVA improved in five patients (from one to five lines), remained unchanged in five patients, and decreased in one patient compared to pretreatment. Subconjunctival bevacizumab injection has a particular potential for the regression of CorNV, especially newly formed within 1 month in patients after chemical burns.

Central retinal thickness changes and risk of neovascular glaucoma after intravitreal bevacizumab injection in patients with central retinal vein occlusion

This retrospective study evaluated changes in the central retinal thickness (CRT) and the risk factors for neovascular glaucoma (NVG) after intravitreal bevacizumab injection under a pro re nata (PRN) regimen for macular oedema in 57 eyes with central retinal vein occlusion (CRVO). The clinical characteristics at the time of NVG diagnosis were assessed, and baseline and final clinical characteristics and mean CRT values at 1-, 3-, and 6-month follow-up evaluations were recorded. The incidence of NVG was 21.1%, with the neovascular group (12 eyes) showing poor baseline and final visual acuity, a higher incidence of baseline ischaemic-type CRVO and subretinal fluid, a higher mean CRT at the 1-month follow-up, and a higher number of intravitreal bevacizumab injections during the 6-month follow-up. Nine eyes with NVG (75%) showed a mean CRT < 300 μm at the time of diagnosis. An ischaemic CRVO and higher CRT at the 1-month follow-up were related to the development of NVG in the multivariate analysis. Thus, NVG development in CRVO patients treated with intravitreal bevacizumab injections was associated with an ischaemic CRVO and elevated CRT at the 1-month follow-up; PRN bevacizumab regimens based on CRT or control of macular oedema did not completely prevent NVG development.

Karakteristik Ketebalan Makula Sentral Sebelum dan Sesudah Injeksi IntravitrealBevacizumab di RSKM Padang Eye Center Periode Januari 2018 – Januari 2019

Macular edema is a common cause of vision disturbing. Fluid accumulation in the retina and increased thickness of the retina cause damage to the blood retinal barrier. Intravitreal anti-VEGF (bevacizumab) injection aims to reduce VEGF activity, where retinal vein occlusion (RVO) induces an increase in VEGF levels which causes an increase in vascular permeability and results in macular edema. The aim of this study was to determine the central macular thickness before and after intravitreal injection of bevacizumab in patients with central retinal vein occlusion and branch retinal vein occlusion through observing the results of OCT (Optical Coherence Tomography) examination. This research is a retrospective descriptive study based on the results of medical records tracing of 8 RVO patients in the Padang Eye Center Hospital for the period January 2018 to January 2019. The study was conducted in March to April 2020. The study subjects consisted of 8 people (8 eyes) consisting of 2 men (25.0%) and 6 women (75.0%). The age range ranges from 41-80 years. The thickness of the central macula at the start was found to be majority &gt; 300 μm, as many as 7 people (87.5%), while ≤ 300 μm was 1 person (12.5%). One month after injection found the majority of central macular thickness ≤ 300 μm by 5 people (62.5%), while&gt; 300 μm is as many as 3 people (37.5%). All patients experienced a decrease in central macular thickness in 8 subjects (100%).

Proteinuria as a Potential Biomarker for the Efficacy of Intravitreal Bevacizumab Injection in Patients with Diabetic Macular Edema

Proteinuria as a Potential Biomarker for the Efficacy of Intravitreal Bevacizumab Injection in Patients with Diabetic Macular Edema

To evaluate the effect of intravitreal bevacizumab on intraocular pressure

Introduction: To assess intraocular pressure variation after intravitreal bevacizumab injection in patients with diabetic macular edema. Materials and Methods: Our prospective study included 20 eyes of patients who received intravitreal injection of 0.05 ml bevacizumab as treatment option for diabetic macular edema. IOP was recorded before the injection, at 3 days, 1week, 1month and 2 months after the intravitreal injection. Results: The mean intraocular pressure before injection was 17.28±3.04 mmHg. The mean IOP post bevacizumab at 3 days, 1 week, 1month and 2 months were 19.98± 3.23mmHg, 18.99±3.67 mmHg, 17.31±3.19 and 17.15±3.10 respectively. There was statistically significant elevation in IOP at 3 days post bevacizumab injection, which reinstated to baseline levels at final follow-up. Conclusion: Our study indicate that intravitreal injection of bevacizumab is associated with short term IOP elevation. Keywords: Bevacizumab, Clinically significant macular edema, Diabetic macular edema, GAT, IOP.

Proteinuria and Renal Dysfunction after Intravitreal Injection of Bevacizumab in Patients with Diabetic Nephropathy: A Prospective Observational Study.

Background: Proliferative diabetic retinopathy (PDR) is one of the most important microvascular complications among the patients with diabetes. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) agent enacts a key role in PDR. Some studies have dealt with the systemic exposure to these agents after intravitreal administration. However, renal dysfunction following this therapy has scarcely been reported. Hence, this study aimed to determine the effect of intravitreal bevacizumab treatment on the deterioration of renal function and proteinuria. Materials and Methods: This present prospective observational study was performed on 40 patients with diabetic nephropathy and PDR and/or significant diabetic macular edema as the candidates for receiving intravitreal injection of bevacizumab. To evaluate renal function, changes in the urinary albumin-to-creatinine ratio (UACR), serum creatinine (SCr), and estimated glomerular filtration rate (eGFR) one month after injection were measured. Also, changes in systolic and diastolic blood pressures (BPs), plasma VEGF level, platelet, white blood cell (WBC) counts, and hemoglobin (Hb) level were measured at the baseline and one month after treatment. Results: The mean age of the patients was 60.3 ± 9.2 years, and 33 patients were female. The decrease in the plasma VEGF level and platelet count, as well as the increase in diastolic BP, and Hb level were significant. However, systolic BP and WBC count remained unchanged. There were no significant changes in UACR, SCr, and eGFR after the injection as compared to baseline (P>0.05). Conclusion: Our study indicated that intravitreal bevacizumab injection was not associated with renal dysfunction and proteinuria in patients with diabetic nephropathy. Nevertheless, diastolic BP and Hb level could increase after one month.

Proteinuria and Renal Dysfunction after Intravitreal Injection of Bevacizumab in Patients with Diabetic Nephropathy: A Prospective Observational Study

Background: Proliferative diabetic retinopathy (PDR) is one of the most important microvascular complications among the patients with diabetes. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) agent enacts a key role in PDR. Some studies have dealt with the systemic exposure to these agents after intravitreal administration. However, renal dysfunction following this therapy has scarcely been reported. Hence, this study aimed to determine the effect of intravitreal bevacizumab treatment on the deterioration of renal function and proteinuria.&#x0D; Materials and Methods: This present prospective observational study was performed on 40 patients with diabetic nephropathy and PDR and/or significant diabetic macular edema as the candidates for receiving intravitreal injection of bevacizumab. To evaluate renal function, changes in the urinary albumin-to-creatinine ratio (UACR), serum creatinine (SCr), and estimated glomerular filtration rate (eGFR) one month after injection were measured. Also, changes in systolic and diastolic blood pressures (BPs), plasma VEGF level, platelet, white blood cell (WBC) counts, and hemoglobin (Hb) level were measured at the baseline and one month after treatment.&#x0D; Results: The mean age of the patients was 60.3 ± 9.2 years, and 33 patients were female. The decrease in the plasma VEGF level and platelet count, as well as the increase in diastolic BP, and Hb level were significant. However, systolic BP and WBC count remained unchanged. There were no significant changes in UACR, SCr, and eGFR after the injection as compared to baseline (P&gt;0.05).&#x0D; Conclusion: Our study indicated that intravitreal bevacizumab injection was not associated with renal dysfunction and proteinuria in patients with diabetic nephropathy. Nevertheless, diastolic BP and Hb level could increase after one month. [GMJ.2018;In press:e1299]

Proteinuria and Renal Dysfunction after Intravitreal Injection of Bevacizumab in Patients with Diabetic Nephropathy: A Prospective Observational Study

Background: Proliferative diabetic retinopathy (PDR) is one of the most important microvascular complications among the patients with diabetes. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) agent enacts a key role in PDR. Some studies have dealt with the systemic exposure to these agents after intravitreal administration. However, renal dysfunction following this therapy has scarcely been reported. Hence, this study aimed to determine the effect of intravitreal bevacizumab treatment on the deterioration of renal function and proteinuria.Materials and Methods: This present prospective observational study was performed on 40 patients with diabetic nephropathy and PDR and/or significant diabetic macular edema as the candidates for receiving intravitreal injection of bevacizumab. To evaluate renal function, changes in the urinary albumin-to-creatinine ratio (UACR), serum creatinine (SCr), and estimated glomerular filtration rate (eGFR) one month after injection were measured. Also, changes in systolic and diastolic blood pressures (BPs), plasma VEGF level, platelet, white blood cell (WBC) counts, and hemoglobin (Hb) level were measured at the baseline and one month after treatment.Results: The mean age of the patients was 60.3 ± 9.2 years, and 33 patients were female. The decrease in the plasma VEGF level and platelet count, as well as the increase in diastolic BP, and Hb level were significant. However, systolic BP and WBC count remained unchanged. There were no significant changes in UACR, SCr, and eGFR after the injection as compared to baseline (P&gt;0.05).Conclusion: Our study indicated that intravitreal bevacizumab injection was not associated with renal dysfunction and proteinuria in patients with diabetic nephropathy. Nevertheless, diastolic BP and Hb level could increase after one month. [GMJ.2018;In press:e1299]

Bevacizumab Injection in Patients with Neovascular Age-Related Macular Degeneration Increases Angiogenic Biomarkers

To evaluate the expression of 19 angiogenic biomarkers in the aqueous humor before and after intravitreal bevacizumab injection (IVB) in eyes with neovascular age-related macular degeneration (AMD). Prospective, noncomparative, interventional case series. Twenty-three eyes of 23 treatment-naïve patients with choroidal neovascularization (CNV) secondary to neovascular AMD. Eyes were diagnosed with CNV secondary to neovascular AMD and were treated with 3 monthly IVBs. Aqueous humor samples were obtained by anterior chamber paracentesis at baseline and immediately before each intravitreal bevacizumab injection. Aqueous humor levels of 19 angiogenic biomarkers (angiopoietin 2, bone morphogenetic protein 9 [BMP-9], epidermal growth factor [EGF], endoglin, endothelin 1, fibroblast growth factor [FGF]-1 and FGF-2, follistatin, granulocyte colony-stimulating factor [GCSF], heparin-binding EGF-like growth factor [HB-EGF], hepatocyte growth factor [HGF], interleukin 8, leptin, placental growth factor [PLGF], vascular endothelial growth factor [VEGF]-A, VEGF-C, VEGF-D, and tissue inhibitor of metalloproteinases [TIMP]-1 and TIMP-2) were measured. Best-corrected visual acuity (BCVA), spectral-domain OCT parameters, and intraocular pressure also were evaluated. Baseline aqueous VEGF-A expression was elevated in all study eyes before treatment initiation. A statistically significant decrease of VEGF-A was observed at the 1- and 2-month follow-ups. A statistically significant increased concentration was observed in 7 biomarkers: VEGF-C, angiopoietin 2, endothelin 1, follistatin, HB-EGF, HGF, and interleukin 8. The other 11 study biomarker levels (VEGF-D, BMP-9, EGF, endoglin, FGF-1, FGF-2, GCSF, leptin, PLGF, TIMP-1, and TIMP-2) did not show any significant difference during follow-up. The BCVA statistically improved significantly at 2 months. Spectral-domain OCT parameters improved significantly at all follow-ups. Mean intraocular pressure values were not statistically different during the study period. Despite a decrease in VEGF-A, the aqueous levels of VEGF-C, angiopoietin 2, endothelin 1, follistatin, HB-EGF, HGF, and interleukin 8 increased significantly after intravitreal injection of bevacizumab. These upregulated angiogenic biomarkers may represent new therapeutic targets in exudative AMD.

Aqueous vascular endothelial growth factor and clinical outcomes correlation after single intravitreal injection of bevacizumab in patients with neovascular age-related macular degeneration

Purpose To evaluate the concentration of vascular endothelial growth factor (VEGF) in aqueous humor after a single intravitreal injection of bevacizumab (IVB) in eyes with neovascular age-related macular degeneration (AMD).MethodsIn this prospective interventional case series study, 24 eyes of 24 patients with types 1 and 2 choroidal neovascularization secondary to neovascular AMD were treated with a single intravitreal injection of bevacizumab. Aqueous humor samples were obtained before the intravitreal injection and at one week, one month, and three months follow-up periods. Best-corrected visual acuity (BCVA) and three spectral-domain optical coherence tomography parameters (central retinal thickness, macular volume and macular area) were also analyzed and correlated with VEGF expression at the baseline and each follow-up period.ResultsAll of the ninety-six aqueous humor study taps were well tolerated by the study patients without adverse events. Increased VEGF levels (mean ± SD = 179.7 ± 88.3 pg/mL) were observed in the aqueous humor of all study patients before the intravitreal injection of bevacizumab. At all follow-up periods, compared to baseline, levels of VEGF significantly reduced (P < 0.0001), and BCVA significantly improved (P < 0.005). The lowest VEGF expression was observed at 1 week, and the greatest BCVA improvement occurred 1 month after treatment. At 1 month, central retinal thickness (CRT), macular volume (MV), and macular area (MA) significantly reduced compared to baseline (P < 0.0001, P = 0.0005, P = 0.007, P = 0.009, respectively). At 1 week and 3 months, although without statistical significance (P > 0.005), CRT, MV and MA also reduced in comparison to baseline.ConclusionsSingle intravitreal bevacizumab injection in eyes with neovascular AMD resulted in a substantial decrease of aqueous VEGF levels 1 week after treatment with the greatest improvement of clinical outcomes occurring at 1 month follow-up.

The effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on the OCT-measured macular choroidal thickness of eyes with proliferative diabetic retinopathy

OBJECTIVES:To investigate the effect of laser pan-retinal photocoagulation with or without intravitreal bevacizumab injections on macular choroidal thickness parameters in eyes with high-risk proliferative diabetic retinopathy.METHODS:High-risk proliferative diabetic retinopathy patients undergoing laser treatment were prospectively enrolled in this study. One eye was randomly selected for laser treatment combined with bevacizumab injections, study group, whereas the corresponding eye was subjected to laser treatment alone, control group. Spectral-domain optical coherence tomography with enhanced depth imaging was used to measure the macular choroidal thickness prior to and 1 month after treatment. Measurements in both groups were compared. Clinicaltrials.gov: NCT01389505.RESULTS:Nineteen patients (38 eyes) with a mean±standard deviation age of 53.4±9.3 years were evaluated, and choroidal thickness measurements for 15 patients were used for comparison. The greatest measurement before treatment was the subfoveal choroidal thickness (341.68±67.66 μm and 345.79±83.66 μm for the study and control groups, respectively). No significant difference between groups was found in terms of macular choroidal thickness measurements at baseline or after treatment. However, within-group comparisons revealed a significant increase in choroidal thickness parameters in 10 measurements in the study group and in only 5 temporal measurements in the control group when 1-month follow-up measurements were compared to baseline values.CONCLUSIONS:The macular choroidal thickness does not appear to be significantly influenced by laser treatment alone but increases significantly when associated with bevacizumab injections in patients with proliferative diabetic retinopathy and macular edema. Because bevacizumab injections reduce short-term laser pan-retinal photocoagulation-induced macular edema, our findings suggest that the choroid participates in its pathogenesis.

The long‐term effect of intravitreal bevacizumab injection in central serous chorioretinopathy

PurposeTo study the effect of intravitreal bevacizumab injection in patients with idiopathic central serous chorioretinopathy.MethodsWe had performed retrospective review on the patients who had been diagnosed as idiopathic central serous chorioretinopathy and had regular follow‐up for at least 12 months from the first injection, either undergone intravitreal bevacizumab injection (107 eyes of 100 patients) or observed without injection (46 eyes of 40 patients). Changes in the visual acuity and the serous neurosensory retinal and retinal pigment epithelium detachment were evaluated through the results of best corrected visual acuity and optical coherence tomography measured at initial presentation, after 1, 3, 6, 9 and 12 months of the first injection.Results87 males and 13 females with mean age of 45.4 ± 7.6 years were recruited in the intravitreal bevacizumab injection (IVB) group, and 34 males and 6 females with mean age of 47.2 ± 9.8 years were recruited in the observation group. There was significant difference in the mean duration of retinal detachment to disappear between the IVB group (2.5 ± 0.2 months) and the observation group (4.3 ± 0.7 months). There was no significant difference in the best corrected visual acuity and the central macular thickness after 12 months follow‐up between the IVB group and the observation group.ConclusionsIntravitreal bevacizumab injection was more effective and faster treatment for resolution of sensory retinal detachment than observation during the 12 months of consecutive follow‐up. Therefore, intravitreal bevacizumab injection can be considered as a significant and safe treatment modality for central serous chorioretinopathy when the patients need prompt visual improvement, such as depending on the morbid eye or requiring binocular vision for occupational cause.

Bevacizumab treatment of macular edema in CRVO and BRVO: long-term follow-up. (BERVOLT study: Bevacizumab for RVO long-term follow-up).

To assess the efficacy and safety of intraocular injections of bevacizumab in patients with macular edema (ME) following branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO). Retrospective, non-comparative case series. Patients ≥18years of age with ME secondary to BRVO or CRVO who received a minimum of one intravitreal injection of bevacizumab with a follow-up >3months were included. Primary endpoints were mean change in best corrected visual acuity (BCVA) from baseline to 12 and 24months, and mean change in central macular thickness (CMT) after 3 injections. Secondary endpoints were mean change in BCVA and CMT from baseline to end of follow-up, number of injections, and ocular adverse events. Eighty-seven eyes with BRVO and 65 eyes with CRVO were included. Mean follow-up time was 24.4 and 26.1months in the BRVO and CRVO groups, respectively. The mean change in BCVA was 0.25 LogMAR in the BRVO group and -0.118 LogMAR in the CRVO group. Visual acuity outcomes in the CRVO group were poorer, especially in patients with low baseline BCVA.

Posterior sub-tenon’s bevacizumab injection in diabetic macular edema; a pilot study

PurposeTo evaluate the short-term results of sub-tenon’s injection of bevacizumab in patients with clinically significant macular edema (CSME). MethodsIn this prospective non-comparative interventional case series, sub-tenon’s injection of 2.5mg/0.1ml bevacizumab was performed for eyes with CSME. Macular thickness and best corrected visual acuity measurements were performed before and one month after injections. ResultsNineteen eyes of twelve patients with a mean age of 59.8±5.7years were evaluated. Thirteen eyes (68.4%) had center-involving macular edema. No significant difference was observed between pre- and post-injection central subfield retinal thickness measurements (P=0.3). Central subfield thickness measurements improved or remained unchanged in 13 eyes (68.4%). Baseline BCVA of 0.48±0.35 LogMAR improved to 0.36±0.26 LogMAR after injection (P=0.01). Improvement of>2 lines in BCVA was found in 5 eyes (26.3%), and no eye lost>2 lines of BCVA. No complication associated with sub-tenon’s injection was observed. ConclusionSub-tenon’s injection of bevacizumab resulted in significant short-term visual improvement in eyes with CSME. Retinal thickness changes were not significant.

Role of Postinjection Antibiotics after Intravitreal Bevacizumab Injection in Preventing Endophthalmitis

Purpose: To evaluate the role of using antibiotics after intravitreal injection of Bevacizumab in patients to prevent postinjection endophthalmitis. Material and Methods: A multicentre prospective case control study was carried out at PUMHSW Hospital Nawabshah and Ghulam Muhammad Mehar Medical college Hospital Sukkhur. The injection was given by different surgeons but with same technique. Immediately after intravitreal Bevacizumab injection the patient was started with Topical Moxifloxacin and oral ciprofloxacin 500 mg for three days. Patients were followed at 1st, 2nd and 4th week post-injection to look for any sign of endophthalmitis. Result: Out of 620 injections given in 480 eyes, 310 were control group without any post-injection medicine and 310 were cases who were given post-injection medicine. No case of proven or suspected endophthalmitis was identified, corresponding to a risk of 0% per injection. Conclusion: In our study use of antibiotics after intravitreal Bevacizumab injection does not make any difference for the prevention of postoperative endophthalmitis. Keywords: Endophthalmitis, Bevacizumab,Intravitreal Antibiotics.

Serum D-Dimer Levels to Evaluate the Risk for Arterial Thromboembolism After Intravitreal Injection of Bevacizumab and Ranibizumab

There are concerns about arterial thromboembolic event after intravitreal injection of bevacizumab or ranibizumab. Motivated by the fact that D-dimer was a sensitive biomarker for thromboembolism, we evaluated serum D-dimer levels in patients with age-related macular degeneration (AMD) after intravitreal injection of bevacizumab and ranibizumab. In this prospective, nonrandomized, uncontrolled study, 122 patients (122 eyes) with AMD were enrolled. Sixty-two eyes received intravitreal injections of bevacizumab and 60 eyes received intravitreal injections of ranibizumab monthly for 3 months. Serum D-dimer levels were measured in patients before intravitreal injection and 1 day, 1 week, 1 month, and 3 months thereafter. Serum D-dimer levels were not significantly altered following injection of either bevacizumab or ranibizumab. Subgroup analysis for patients at risk for thromboembolic events revealed that serum D-dimer levels showed no significant change after injection of ranibizumab. However, D-dimer levels significantly increased at 1 day (P=0.041) and 1 week (P=0.022) after injection of bevacizumab. Serum D-dimer levels were not changed after injection with either bevacizumab or ranibizumab. In subgroup analysis, bevacizumab injection in patients at risk of thromboembolism increased serum D-dimer levels.