Complementary effects of bevacizumab and <scp>MMC</scp> in the improvement of surgical outcome after glaucoma filtration surgery

Bergen, Tine Van; Vandewalle, Evelien; Moons, Lieve; Stalmans, Ingeborg

doi:10.1111/aos.12766

Cited by 22 publications

(17 citation statements)

References 43 publications

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“…16 Although intravitreal injection of bevacizumab has not received FDA approval, bevacizumab has been widely used off-label to treat VEGF-mediated ocular conditions such as choroidal neovascularization secondary to age-related macular degeneration, diabetic macular edema, CRVO-associated macular edema and as an adjunctive agent in glaucoma surgery. [17][18][19][20][21] The outcomes of off-label treatment of NVG with intravitreal bevacizumab have been reported. [22][23][24][25][26][27][28][29][30] We have previously published a retrospective interventional case series of NVG eyes describing the natural history of NVG treated with intravitreal bevacizumab.…”

Section: Introductionmentioning

confidence: 99%

Long-term outcomes of neovascular glaucoma treated with and without intravitreal bevacizumab

Olmos

Sayed

Moraczewski

et al. 2015

Eye

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Aims To compare the outcomes of neovascular glaucoma (NVG) treated with and without intravitreal bevacizumab in a large case comparison study. Methods The study is a retrospective, comparative, case series of 163 eyes of 151 patients with NVG, including 99 treated without and 64 treated with intravitreal bevacizumab. Medical and surgical treatments for NVG were assessed. The main outcome measures were visual acuity (VA) and intraocular pressure (IOP).Results At the time of NVG diagnosis, the median VA was count fingers (CF) in the non-bevacizumab group and 2/300 in the bevacizumab group. IOP (mean ± SD) was 43.1 ± 13.0 mm Hg in the non-bevacizumab group and 40.8 ± 11.5 mm Hg in the bevacizumab group. IOP (mean ± SD) decreased to 18.3 ± 13.8 mm Hg in the nonbevacizumab group and 15.3 ± 8.0 mm Hg in the bevacizumab group, and the median VA was CF in both treatment groups at a mean follow-up of 12 months. Panretinal photocoagulation (PRP) substantially reduced the need for glaucoma surgery (Po0.001) in bevacizumab treated NVG eyes. Conclusions Although bevacizumab delayed the need for glaucoma surgery, PRP was the most important factor that reduced the need for surgery. Vision and IOP in eyes with NVG treated with bevacizumab showed no long-term differences when compared with eyes that were not treated with bevacizumab. Thus, intravitreal bevacizumab serves as an effective temporizing treatment, but is not a replacement for close monitoring and definitive treatment of NVG. PRP remains the treatment modality that affects the course of NVG in terms of decreasing the need for surgery to control IOP.

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Section: Introductionmentioning

confidence: 99%

Long-term outcomes of neovascular glaucoma treated with and without intravitreal bevacizumab

Olmos

Sayed

Moraczewski

et al. 2015

Eye

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“…9,10 Shortly, pictures were taken at a magnification of 320, a resolution of 2584 3 1936 pixels and morphometric analyses were performed using commercial software (KS300; Zeiss). The percentage of the area of Sirius Red-stained mature collagen fibers to the total wound area was measured to determine collagen deposition in the bleb.…”

Section: Microscopy Analysismentioning

confidence: 99%

“…9,17,18 The rabbit model for trabeculectomy was used, since the volume of AH that can be collected from a mouse is too small to be used in the PlGF immunoassay. Analysis showed that the first day after surgery, PlGF levels were significantly upregulated after MMC administration by 1.5 6 0.39-fold compared to control eyes treated with NaCl (n ¼ 10; P ¼ 0.01 versus baseline; Fig.…”

Section: Upregulation Of Plgf In Aqueous Humor After MMC Administrationmentioning

confidence: 99%

“…7,8 Moreover, bevacizumab in combination with mitomycin-C (MMC) showed complementary effects in the improvement of surgical outcome in a mouse model of GFS. 9 Although bevacizumab, with or without MMC, can improve surgical outcome by inhibiting angiogenesis and deposition of collagen, it is not able to reduce inflammation, another important process in postoperative healing. 5 This can probably be explained by the concomitant upregulation of other proinflammatory proteins, like placental growth factor (PlGF), after bevacizumab administration.…”

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confidence: 99%

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The Combination of PlGF Inhibition and MMC as a Novel Anti-Scarring Strategy for Glaucoma Filtration Surgery

Bergen

Jonckx²,

Moons

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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“…17 Experimentally bevacizumab not only enhances the beneficial effect of MMC on trabeculectomy outcome, but also allows reducing the toxicity of MMC via reducing its exposure time in mouse model. 18 This study was conducted to evaluate the additive effect of intraoperative subconjunctival bevacizumab to MMC-augmented trabeculectomy in recurrent pediatric glaucoma concerning its efficacy, safety, and timing (shortly before glaucoma drainage devices or cyclodestructive procedures become mandatory).…”

Section: Introductionmentioning

confidence: 99%

Evaluation the adjunctive use of combined bevacizumab and mitomycinc to trabeculectomy in management of recurrent pediatric glaucoma

Mahdy

Al-Mosallamy

Al-Aswad

et al. 2015

Eye

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Purpose To evaluate the efficacy and safety of combined bevacizumab-mitomycin c (MMC) in recurrent cases of pediatric glaucoma. Methods A prospective non-masked controlled study that included bilateral cases of 12 patients (24 eyes) with recurrent (had previous glaucoma surgery before) pediatric glaucoma. One eye in each patient (12 eyes) was assigned to trabeculectomy operation with combined application of MMC (0.4 mg/ml for 3 min) under and around the scleral flap before trabeculectomy and bevacizumab (avastin) (2.5 mg in 0.2 ml) injected subconjunctivally around the bleb after completing the surgery (group I). The other eye of each patient (12 eyes) was assigned to trabeculectomy operation with application of MMC (0.4 mg/ml for 3 min) only (group II). The mean follow-up period was 13 ± 1 months.

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Complementary effects of bevacizumab and MMC in the improvement of surgical outcome after glaucoma filtration surgery

Abstract: Adjunctive bevacizumab not only enhances the beneficial effect of MMC on surgical outcome, but also allows reducing the administration time of MMC 0.02%, thereby eliminating its toxic effects on the cornea.

Cited by 22 publications

References 43 publications

Long-term outcomes of neovascular glaucoma treated with and without intravitreal bevacizumab

Long-term outcomes of neovascular glaucoma treated with and without intravitreal bevacizumab

The Combination of PlGF Inhibition and MMC as a Novel Anti-Scarring Strategy for Glaucoma Filtration Surgery

Evaluation the adjunctive use of combined bevacizumab and mitomycinc to trabeculectomy in management of recurrent pediatric glaucoma

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