Single Intravitreal Injection Of Bevacizumab Research Articles

Intravitreal Bevacizumab for Retinopathy of Prematurity

To evaluate the therapeutic effect of a single intravitreal injection of bevacizumab for treatment of threshold retinopathy in retinopathy of prematurity (ROP). The retrospective study consisted of all infants who developed threshold ROP in fundus zone I or zone II and who consecutively received an intravitreal injection of bevacizumab (0.375 mg, 0.03 mL) in local anesthesia. Twelve infants (23 eyes) were included into the study. The mean birth weight was 625±187 g (mean±standard deviation; range: 450-810 g), mean gestational age was 25.1±1.4 weeks (range: 24.0-28.7 weeks), mean age at the time of intervention was 38.1±3.7 gestational weeks (range: 32.1-45.6 weeks), and mean follow-up was 30.4±25.9 weeks. Three children (6 eyes) showed aggressive posterior ROP. After the injection, all eyes showed a regression of plus disease within 2-6 days, a decrease in pupillary rigidity, a resolution of any tunica vasculosa lentis, and a complete regression of the retinal neovascularization within 2-3 weeks. In none of the children a second intravitreal injection of bevacizumab was performed. A single intravitreal bevacizumab injection of 0.375 mg in 0.03 mL appears to be potentially helpful for the therapy of threshold ROP avoiding side effects of conventional retinal laser coagulation such as irreversible retinal scarring. Long-term effects and side effects may be assessed in future prospective randomized trials.

Effects of Intravitreally Injected Bevacizumab on Vascular Endothelial Growth Factor in Fellow Eyes

Whether an intravitreal injection of bevacizumab in 1 eye will have any effect on the fellow eye has been discussed. The aim of this study was to determine the level of vascular endothelial growth factor (VEGF) in the fellow eyes after an intravitreal injection of bevacizumab in 1 eye with proliferative diabetic retinopathy. Eight patients who had similar findings of proliferative diabetic retinopathy in both eyes were studied. Four patients had rubeosis (rubeosis group), and 4 patients did not have rubeosis (no-rubeosis group) in the anterior chamber. All patients received an intravitreal injection of bevacizumab (1.25 mg) in 1 eye. Samples of aqueous humor were collected from the injected eyes just before the injection of bevacizumab and 1 day after the first injection just before vitrectomy. Samples of aqueous humor from the fellow eyes were collected just before a second injection of bevacizumab in the fellow eye at 7 days after the first injection. The concentration of VEGF in the aqueous humor was measured by enzyme-linked immunosorbent assay. After 1 day, the concentration of VEGF in injected eyes was significantly reduced from 3,230.3±2,136.8 to 3.1±3.6 pg/mL (P<0.05) in eyes with rubeosis and 465.0±78.8 to 0 pg/mL (P<0.05) in those without rubeosis. After 7 days, the VEGF level of the fellow eyes was still significantly lower than that in the injected eye just before the injection of bevacizumab (688.5±443.1 pg/mL) in the rubeosis group, and it was 7.8±13.2 pg/mL in the no-rubeosis group (P<0.05). A single intravitreal injection of bevacizumab significantly reduced the VEGF concentrations in the aqueous humor of the fellow untreated eye. Thus, we need to be observant of the fellow eyes after a unilateral injection and also examine the patients for systemic changes.

DIFFERENT DOSING OF INTRAVITREAL BEVACIZUMAB FOR CHOROIDAL NEOVASCULARIZATION BECAUSE OF PATHOLOGIC MYOPIA

To compare the visual outcomes and retreatment rate of single injection of intravitreal bevacizumab followed by pro re nata (PRN) treatment and three monthly injections of intravitreal bevacizumab followed by PRN treatment for myopic choroidal neovascularization. Thirty-one consecutive eyes of 31 patients with myopic choroidal neovascularization were retrospectively evaluated. Nineteen eyes were treated with a single injection + PRN and 12 eyes with 3 monthly injections + PRN. The best-corrected visual acuity 12 months after the initial injection, logarithm of the minimum angle of resolution gain from baseline, recurrence rate, and number of injections were statistically compared. Baseline best-corrected visual acuity (logarithm of the minimal angle of resolution) was 0.42 ± 0.31 in the single injection + PRN group and 0.47 ± 0.29 in the 3 monthly injections + PRN group (P = 0.64). The best-corrected visual acuity improved significantly at 3, 6, and 12 months in both groups (P < 0.05 at each time point). Mean logarithm of the minimal angle of resolution gain at 3, 6, and 12 months did not differ significantly between groups. The single injection + PRN group required significantly fewer intravitreal bevacizumab treatments (P = 0.005). The rate of recurrence and choroidal neovascularization persistence did not differ significantly between groups. Compared with 3 monthly injections followed by PRN, single injection followed by PRN for myopic choroidal neovascularization required fewer injections and produced a similar visual outcome over 12 months.

Traitement par injection intravitréenne de bevacizumab de néovaisseaux choroïdiens compliquant une maladie de Best

Best's disease is an autosomal-dominant macular dystrophy, which might lead to choroidal neovascularization. The case of a 9-year-old boy followed up for a Best's disease is hereby reported. The boy was referred to our service department for a decrease in visual acuity in his right eye. Ophthalmoscopic examination revealed a foveolar vitelliform lesion, complicated by a choroidal neovascularization. The patient received a single intravitreal bevacizumab injection, which led to a complete resolution of intraretinal fluid and a significant reduction in neovascularization size. Visual acuity also improved. This case underlines the efficiency efficacy of intravitreal anti-VEGF therapy for choroidal neovascularization in Best's disease.

Descending doses of intravitreal bevacizumab for the regression of diabetic neovascularization

To report short-term regression of neovascularization after varying intravitreal doses of bevacizumab (Avastin®; Genentech, San Francisco, California, USA) in patients with proliferative diabetic retinopathy (PDR). Eighty eyes from 76 patients with active neovascularization of the disc (NVD) or elsewhere (NVE) caused by PDR were divided into four groups and treated with a single intravitreal bevacizumab (IVB) injection of 1.25 mg, 600 μg, 300 μg or 150 μg, respectively. All patients underwent ophthalmoscopic examination and fluorescein angiography at baseline, 1 week, 1 month and 2 months later. No significant ocular or systemic adverse events were observed. In all patients with NVD or NVE, complete resolution of leakage was recorded within the first week or the first month of the injection. Even with the lowest dose (150 μg), regression of neovascularization appeared as early as the first week and lasted for over a month. Recurrence of fluorescein leakage was observed in all groups after the first month and did not correlate with the extent of neovascularization or IVB dose. Short-term results suggest that IVB given below the standard dosage (150–300 μg compared to 1.25 mg) can lead to the achievement of complete regression of diabetic retinal neovascularization within 30–45 days of injection.

Intravitreal bevacizumab in retinopathy of prematurity: an interventional case series

To evaluate the results of intravitreal bevacizumab in terms of regression of retinopathy of prematurity (ROP). In this interventional case series, 12 eyes from January 2007 to December 2008 were included. Two groups of patients were considered. Group 1 included those ROP patients who did not respond to conventional laser therapy within 3weeks or had some complications (hyphema or vitreous hemorrhage) after conventional laser therapy; intravitreal injection (0.625mg) was performed as an adjuvant therapy. Group 2 included those with aggressive posterior ROP who received single intravitreal bevacizumab injection as the initial treatment. Ten eyes of 12 patients with mean gestational age of 28.5 (range: 26-32) weeks and birth weight of 1,218 grams (range: 900-1,630) were included in the study. Mean conceptional age at the time of first visit was 40weeks (30-48weeks). All the patients had a history of supplemental oxygen. Eight patients (26.3%) were under mechanical ventilation. Eight eyes received bevacizumab after conventional laser therapy (group 1). Four eyes received intravitreal bevacizumab as the initial therapy (group 2). All of the patients were followed up for at least 1year. All patients in group 1 responded to this adjuvant (intravitreal bevacizumab) treatment within 1week, but two eyes of group 2 needed laser therapy 1.5month after intravitreal bevacizumab injection in spite of the initial treatment response. No complications such as cataract, endophthalmitis or retinal detachment occurred. The use of intravitreal bevacizumab injection in premature eyes was well-tolerated, and induced prompt regression as an adjuvant therapy after conventional laser therapy and also as an alternative therapy in the management of aggressive retinopathy of prematurity.

Role of intravitreal bevacizumab in adult onset Coats’ disease

To evaluate the role of intravitreal bevacizumab in the treatment of Coats' disease diagnosed in adulthood. Prospective, interventional case series. Three patients with Coats' disease diagnosed in adulthood were managed with a single intravitreal injection of bevacizumab (1.25mg) with peripheral laser photocoagulation 3weeks later. All three patients had exudation at the macula (Stage 2B) along with peripheral retinal telangiectasia and aneurysms. They were followed up for 9months. An appreciable reduction in the exudation at the macula and macular edema was observed in all cases following intravitreal bevacizumab therapy. In all patients, the visual acuity improved, and no signs of recurrence were observed at the final follow-up at 9months. Intravitreal bevacizumab injections may be effective as an adjunctive treatment for adult-onset Coats' disease with foveal exudation along with laser photocoagulation to the peripheral retinal vascular abnormalities. Intravitreal bevacizumab was well tolerated by our patients, and no adverse effects were observed.

Intravitreal triamcinolone acetonideversuscombined intravitreal bevacizumab and dexamethasone in diffuse diabetic macular oedema

To compare the efficacy of a single injection of combined intravitreal dexamethasone and bevacizumab (Avastin) with that of intravitreal triamcinolone acetonide in eyes with diffuse cystoid diabetic macular oedema. Prospective, non-randomized, masked, interventional case series. Twenty-four eyes of 24 subjects with centre-involved diabetic macular oedema extending over two disc-areas with predominant cystic changes on spectral domain optical coherence tomography were selected. Ten phakic and two pseudophakic, ocular hypertensive eyes received intravitreal dexamethasone and bevacizumab as against 12 pseudophakic, normotensive eyes that received intravitreal triamcinolone acetonide. Change in central macular volume on spectral domain optical coherence tomography and best-corrected visual acuity were measured at 6-week follow-up. Baseline data were matched in both groups. Post-injection central macular volume (7.46 ± 0.73 mm(3)) was significantly lower (P < 0.001) in the intravitreal triamcinolone acetonide group when compared with its pre-injection central macular volume (9.11 ± 1.0 mm(3)) or when compared with the post-injection central macular volume (P = 0.02) of the intravitreal dexamethasone and bevacizumab group (8.42 ± 1.18 mm(3)). However, post-injection best-corrected visual acuity between the intravitreal triamcinolone acetonide (0.65 ± 0.15 logMAR) and the intravitreal dexamethasone and bevacizumab groups (0.685 ± 0.15 logMAR) was not significantly different (P = 0.06) at 6 weeks. No significant correlation was noted between change in central macular volume and change in best-corrected visual acuity (r = 0.35, P = 0.07) from the pooled data of both the groups. A fair correlation was noted between change in central macular volume and pre-injection central macular volume (r = 0.55, P = 0.005). Intravitreal triamcinolone acetonide may be more effective than intravitreal dexamethasone and bevacizumab in reducing macular volume in patients with diffuse cystoid diabetic macular oedema. A significant reduction in macular volume does not necessarily translate into a correspondingly significant improvement in best-corrected visual acuity.

Long-term effect of early intervention with single intravitreal injection of bevacizumab followed by panretinal and macular grid photocoagulation in central retinal vein occlusion (CRVO) with macular edema: A pilot study

To evaluate the effect of single-dose intravitreal bevacizumab followed by panretinal and macular grid laser, early in the course of central retinal vein occlusion (CRVO). It is a prospective, non-randomized, interventional study of nine eyes of nine patients with <10 days origin of CRVO who received 2.5 mg (0.1 ml) intravitreal bevacizumab, followed 3 weeks later by panretinal and macular grid photocoagulation. Its effect on visual acuity and anatomical features of CRVO were studied. Nine eyes of nine patients (male : female = 8 : 1, mean age 54 years), with <10 days (average 2.67 days) onset of CRVO, received intravitreal bevacizumab within 7 days of presentation (average 3.1 days) followed 3 weeks later by panretinal with macular grid laser. Presenting mean baseline visual acuity was 20/320 (1.2 logarithm of the minimum angle of resolution (LOGMAR) units). All the patients showed rapid improvement in the form of rapid clearance of retinal hemorrhages, decreased optic disc swelling and venous dilation, and tortuosity. Mean final visual acuity was 20/63 (0.5 LOGMAR units). No patient showed conversion from non-ischemic to ischaemic CRVO, recurrence of macular edema, and disc collateral formation. Early intravitreal bevacizumab followed by panretinal and macular grid laser may provide visually and anatomically favourable results in a case of CRVO. It may also obviate the need for repeated injection. It requires a large randomized study to substantiate the results.

Intravitreal Bevacizumab (Avastin) as an Adjuvant for the Treatment of Posterior Scleritis

We report a case of posterior scleritis effectively managed with intravitreal bevacizumab. A 71-year-old woman was diagnosed with posterior scleritis. Although she was initially treated with systemic steroids, her clinical presentation deteriorated. She was then treated with a single intravitreal injection of bevacizumab and aqueous humor collection. The aqueous level of vascular endothelial growth factor prior to the intravitreal injection was 880.51 pg/mL, greater than that in the healthy control group (p < 0.001). One month later, the scleritis was completely resolved, and the patient remained stable during six months of follow-up. Intravitreal bevacizumab appears to be an effective adjuvant therapy for patients with posterior scleritis.

Effect of Intravitreal Bevacizumab on Vascular Endothelial Growth Factor Expression in Patients with Proliferative Diabetic Retinopathy

PurposeTo investigate the effect of bevacizumab (Avastin; Genentech, San Francisco, CA, USA) on vascular endothelial growth factor (VEGF) expression and inflammation in fibrovascular membranes in patients with proliferative diabetic retinopathy (PDR).Materials and MethodsFibrovascular membranes from 19 eyes of 18 patients with PDR were studied using immunohistochemistry and analyzed in the following 3 groups; group 1: 4 inactive PDR eyes, group 2: 10 active PDR eyes treated preoperatively with adjunctive intravitreal bevacizumab, group 3: five active PDR eyes not treated preoperatively with bevacizumab. Immunohistochemical staining for VEGF, CD31 and CD68 were done.ResultsThe immunoreactivity to VEGF and CD 31-positive blood vessels was significantly higher in membranes from group 3 than group 1 (p = 0.007 for VEGF, 0.013 for CD 31-positive vessels). Intravitreal bevacizumab caused a reduction in VEGF expression and vascular densities in 4 out of 10 (40%) excised membranes from eyes with PDR. However, six membranes (60%) in group 2 still demonstrated relatively strong VEGF expression and high vascular density. Infiltration of macrophages was observed in 16 out of the 19 membranes, and the density of macrophages was increased in group 2 compared with group 1 (p = 0.043).ConclusionIntravitreal bevacizumab injections caused some reduction in VEGF expression and vascular densities in a limited number of active PDR patients. A single intravitreal bevacizumab injection may not be enough to induce complete blockage of VEGF and pathologic neovascularization in active PDR patients. Repeated injections, panretinal photocoagulation and/or PPV may be necessary following intravitreal bevacizumab to reinforce the anti-VEGF effect of the drug.

Effects of intravitreally injected bevacizumab on vascular endothelial growth factor in fellow eyes

Abstract Purpose To determine the level of vascular endothelial growth factor (VEGF) in the fellow eyes after an intravitreal injection of bevacizumab in one eye. Methods Eight patients who had similar findings of with proliferative diabetic retinopathy (PDR) in both eyes were studied (four patients had rubeosis, and four patients did not have rubeosis in the anterior chamber). All patients received an intravitreal injection of bevacizumab(1.25 mg) in one eye. Samples of aqueous humor were collected from the injected eyes just before and one day after the injection, and after 7 days from untreated fellow eyes. The concentration of VEGF was measured by ELISA. Results After one day, the VEGF level in injected eyes was significantly reduced from 3230.3±2136.8 pg/ml to 3.1±3.6 pg /ml (P&lt;0.05) in eyes with rubeosis and 465.0±78.8 pg/ml to 0 pg/ml (P&lt;0.05) in those without rubeosis. After seven days, the VEGF levels of the fellow eyes were still significantly lower than that in the injected eyes before the injection (688.5±443.1 pg/ml in the rubeosis group, and 7.8±13.2 pg/ml in the no rubeosis group, P&lt;0.05, P&lt;0.05). Conclusion A single intravitreal injection of bevacizumab significantly reduced the VEGF concentrations in the aqueous humor of the fellow untreated eye.

Histopathology of Neovascular Tissue From Eyes With Proliferative Diabetic Retinopathy After Intravitreal Bevacizumab Injection

To examine the histopathologic effect of a single intravitreal injection of bevacizumab on newly formed vessels in eyes with proliferative diabetic retinopathy (PDR). Interventional case series and laboratory investigation. Two days after intravitreal injection of bevacizumab (1.25 mg/eye), pars plana vitrectomy or trabeculectomy was performed for the treatment of PDR or neovascular glaucoma (NVG) associated with PDR. Ten surgically removed preretinal proliferative tissues and 6 deep scleral flaps containing trabecular meshwork were fixed in 2% glutaraldehyde or 4% paraformaldehyde and were subjected to transmission electron microscopic analysis, immunohistochemical analysis, and terminal deoxyuridiine triphosphate (dUTP) nick-end labeling staining. Two surgically removed preretinal proliferative tissues and 2 deep scleral flaps from patients with PDR and NVG, but without preoperative intravitreal injection of bevacizumab (IVB), served as controls. In control tissues, vascular endothelial cells possessed many fenestrations and were accompanied by pericytes. Apoptotic vascular endothelial cells frequently were observed in tissue after intravitreal injection of bevacizumab, whereas they were not observed in control tissues. Additionally, no apparent fenestration was observed in newly formed vessels from either proliferative tissue or trabecular meshwork after intravitreal injection of bevacizumab. In both PDR and NVG tissues after intravitreal injection of bevacizumab, overexpression of smooth muscle actin was observed in newly formed vessels, suggesting that the treatment may have increased pericytes on the vasculature as compared with control tissue. Intravitreal injection of bevacizumab may induce changes in immature, newly formed vessels of PDR or NVG tissue, leading to endothelial apoptosis with vascular regression, while inducing normalization of premature vessels by increasing pericyte coverage and reducing vessel fenestration.

DOSE OF INTRAVITREAL BEVACIZUMAB (AVASTIN) USED AS PREOPERATIVE ADJUNCT THERAPY FOR PROLIFERATIVE DIABETIC RETINOPATHY

The purpose of this study was to examine the effect of lower than usual doses of intravitreal bevacizumab (Avastin) on vitreous vascular endothelial growth factor (VEGF) concentration and intraoperative bleeding when used as preoperative adjunct therapy in patients undergoing vitrectomy for proliferative diabetic retinopathy. Fifty-two eyes (52 patients) with indications for vitrectomy were studied; 12 received bevacizumab, and 40 did not. The bevacizumab group was given a single intravitreal injection of bevacizumab (0.16-1.25 mg) 3 days before vitrectomy. Numbers of intraoperative coagulation spots administered for hemostasis were compared between the two groups. In both groups, vitreous samples were collected during vitrectomy, and VEGF levels were measured by enzyme-linked immunosorbent assay. The VEGF concentration was 1880.1 +/- 1927.5 in the nonbevacizumab group and 24.9 +/- 25.1 in the bevacizumab group, and the difference was significant (P = 0.0001). Although VEGF concentrations were apparently lower at higher bevacizumab doses, no significant correlation was observed (r = 0.366, P = 0.2425). Numbers of intraoperative coagulation spots differed significantly between the bevacizumab (3.2 +/- 0.8) and nonbevacizumab (5.7 +/- 1.0) groups (P < 0.0001). In the bevacizumab group, there was no correlation between the number of intraoperative coagulation spots and the bevacizumab dose (r = 0.272, P = 0.3919). When intravitreal bevacizumab was administered as preoperative adjunct therapy to patients undergoing vitrectomy for proliferative diabetic retinopathy, the lowest dose tested (0.16 mg) was as effective as the standard dose (1.25 mg) in reducing vitreous VEGF concentrations and also decreasing intraoperative bleeding as measured by the reduced number of coagulation spots.

MACULAR FUNCTIONAL CHANGES EVALUATED WITH MP-1 MICROPERIMETRY AFTER INTRAVITREAL BEVACIZUMAB FOR SUBFOVEAL MYOPIC CHOROIDAL NEOVASCULARIZATION

The purpose of this study was to evaluate 1-year functional and structural effects of intravitreal bevacizumab for subfoveal choroidal neovascularization secondary to pathologic myopia (myopic choroidal neovascularization). Fifteen eyes with myopic choroidal neovascularization participated in this prospective interventional, noncomparative case series. All patients were treated with one intravitreal injection of 1.25 mg bevacizumab. Retreatments were performed in case of persistent or recurrent leakage on fluorescein angiography and/or intraretinal fluid on optical coherence tomography. Evaluation of best-corrected visual acuity using Early Treatment of Diabetic Retinopathy Study criteria, MP-1 microperimetry, optical coherence tomography, and fluorescein angiography were performed before treatment and 1 month, 3 months, 6 months, and 1 year after treatment. After a follow-up of 12 months, best-corrected visual acuity improved on average of 0.23 logarithm of the minimum angle of resolution. Mean macular sensitivity within the central 8 degrees increased on average of 2.62 dB at 12-month postinjection. The mean number of measurement points within the central absolute scotoma reduced significantly from 12.47 before treatment to 6.27 at 1-year follow-up. An improvement of fixation stability from baseline was observed in 9 patients (60%). No treatment adverse events were evidenced. Improvement of macular sensitivity and fixation stability 1 year after intravitreal bevacizumab for myopic choroidal neovascularization suggest a stable and progressive macular function recovery. The mean treatment session was 1.53, with 53.3% of patients needing only a single intravitreal bevacizumab injection, supporting a potential long-lasting efficacy of intravitreal bevacizumab treatment.

Long-Term Tolerability and Serum Concentration of Bevacizumab (Avastin) when Injected in Newborn Rabbit Eyes

PURPOSE. To test the long-term effects and systemic exposure level after single or multiple bevacizumab (Avastin) intravitreal injections in newborn rabbit eyes. METHODS. Four groups of newborn New Zealand rabbits received a single intravitreal bevacizumab injection at a concentration of 1.25 mg/0.05 mL at the ages of 2 (group 1), 4 (group 2), 6 (group 3), and 12 (group 5) weeks. The other group of rabbits (group 4) received three consecutive injections of bevacizumab at a concentration of 1.25 mg/0.05 mL at weeks 2, 6, and 10. Eight days after injection, the serum concentration of bevacizumab was determined in groups 1, 2, 3, and 5. Morphologic and functional changes were evaluated 12 months after bevacizumab injection. RESULTS. Twelve months after either single or multiple intravitreal injections of bevacizumab, newborn rabbit eyes showed no significant differences compared with control eyes on examination with funduscopy, histopathology, or electroretinogram. The serum concentrations when the injections were performed at the ages of 2 (19.4 +/- 8.1 microg/mL) and 4 (10.2 +/- 2.3 microg/mL) weeks were significantly higher than the serum level detected when the injection was performed at 12 weeks of age (2.8 +/- 1.2 microg/mL, P = 0.02 and P = 0.024, respectively). CONCLUSIONS. After 1 year, single and three consecutive intravitreal injections of 1.25 mg bevacizumab in newborn rabbit eyes are well tolerated. Systemic exposure is higher when the injection is performed at an early age.

Intravitreal bevacizumab for posterior capsule neovascularization

We report a case of rapid regression of extensive posterior capsule neovascularization in a 67-year-old diabetic male patient, who developed posterior capsule opacity with neovascularization one year post cataract surgery, after a single injection of intravitreal bevacizumab (Avastin) followed by neodymium:YAG capsulotomy. Rapid regression of the posterior capsule neovascularization, and visual improvement was observed 9 days after the intervention. Posterior capsulotomy was performed successfully without bleeding. Prior to posterior capsulotomy, intravitreal bevacizumab can result in rapid and dramatic regression of posterior capsule neovascularization.

Dynamic retinal vessel response to flicker in age-related macular degeneration patients before and after vascular endothelial growth factor inhibitor injection

Retinal vessel responses to flickering light are different in various systemic and ocular diseases and can be improved after successful therapy. We investigated retinal vessel response to flickering light in age-related macular degeneration (AMD) patients before and after treatment with a single intravitreal bevacizumab (Avastin(®) ) injection. In 10 patients with exudative AMD [age: median (1.quartile; 3.quartile) 76.0 (73.5; 80.0) years], retinal vessel reactions were examined by Dynamic Vessel Analyser (DVA) before and 3 months after a single intravitreal application of bevacizumab (1.25 mg). A baseline measurement was followed by three consecutive monochromatic flicker stimulations (530-600 nm, 12.5 Hz, 20 seconds). Temporal retinal vessel reaction was analysed and compared with the reaction in healthy controls. Mean arterial dilation at the end of flicker was not different in all groups. For veins this parameter amounted to: pre-treatment, 2.6 (1.7; 3.9)%; post-treatment, 2.9 (2.4; 4.0)%; control, 4.3 (3.2; 5.7)%; significant: pre-treatment - control (Dunnett's procedure, p < 0.05). Maximal dilation occurred in arteries at: pre-treatment, 17.5 (14.8; 32.5) seconds; post-treatment, 18.0 (16.6; 30.6) seconds; control, 14.5 (10.8; 17.3) seconds. Both AMD groups were slower (p < 0.05): in veins at 17.0 (14.5; 20.0) seconds, 12.8 (8.6; 14.8) seconds and 18.5 (17.1; 19.9) seconds, respectively; significant post-treatment - control (p < 0.05). In the post-treatment AMD group arterial constriction after stimulation occurred more slowly compared with the control group (p < 0.05). Dynamic retinal arterial and venous reactions to flickering light are altered in AMD compared with controls. Three months after a single injection of a vascular endothelial growth factor inhibitor, the investigated retinal dynamic vascular parameters were not altered in our study.

Successful treatment of choroidal neovascular membrane in retinitis pigmentosa with intravitreal bevacizumab

We report a rare association of choroidal neovascularization (CNV) with retinitis pigmentosa and note its resolution by intravitreal injection of the anti-vascular endothelial growth factor (VEGF), bevacizumab. A classic choroidal neovascular membrane was seen in the right eye (RE) of a patient with sector retinitis pigmentosa. Bevacizumab 1.25 mg in 0.05 ml was injected intravitreally. The choroidal neovascular membrane was seen to regress following this single intravitreal bevacizumab injection with formation of a scar. CNV has very rarely been seen in association with retinitis pigmentosa. Anti-VEGF drugs have been shown to have a beneficial role in CNV with other causes; in this case their effectiveness in CNV associated with retinal dystrophies, for example retinitis pigmentosa, has been demonstrated.

Comparison of Intravitreal Triamcinolone Versus Bevacizumab in Bilateral Diabetic Macular Edema by Optical Coherence Tomography (OCT) Patterns

Purpose: To compare the effect of single intravitreal injection of triamcinolone acetonide and bevacizumab for the treatment of diabetic macular edema by optical coherence tomography (OCT) patterns. Methods: We classified diabetic macular edema by three OCT patterns: Type 1, diffuse retinal thickening; Type 2, increased retinal thickness associated with the presence of intraretinal cystoid spaces (cystoid spaces with horizontal diameter ＞300 m); and Type 3, serous macular detachment. According to this classification, 84 eyes of 42 patients with bilateral diabetic macular edema by the same OCT pattern participated in this study.In each patient,one eye was treated with a single intravitreal injection of bevacizumab 1.25 mg/0.05 ml (IVBI group) and the other eye with a single intravitreal injection of 4 mg/0.1 ml triamcinolone (IVTI group). A comprehensive ophthalmic examination was performed at baseline and at one, three and six months after treatment. Main outcome measures included best corrected visual acuity (logMAR) and central macular thickness measured with OCT. Results: In Type 1, central macular thickness (CMT) reduced significantly in the IVBI group at one month.In Type 2, mean BCVA and CMT improved significantly in the IVTA group at one and three months and in the IVBI group at one month following treatment. In Type 3, CMT reduced significantly in both groups at one, three and six months.However, BCVA did not significantly increase in either group at one, three or six months after treatment. Conclusions: The effects of one single intravitreal injection of triamcinolone and bevacizumab differ by OCT patterns in bilateral diabetic macular edema patients.The correct therapeutic method, depending on OCT patterns of macular edema, should result in better improvement of visual acuity.