Implications of bevacizumab on vascular endothelial growth factor and endostatin in human choroidal neovascularisation

Tatar, Olcay; Shinoda, Kei; Kaiserling, E.; Claes, C; Eckardt, Claus; Eckert, Tillmann; Pertile, Grazia; Scharioth, Gábor B.; Yoeruek, Efdal; Szurman, Peter; Bartz-Schmidt, Karl-Ulrich; Grisanti, Swaantje

doi:10.1136/bjo.2008.138594

Cited by 9 publications

(8 citation statements)

References 46 publications

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“…10 Bevacizumab, however, seems to inhibit angiogenesis by reducing VEGF expression in addition to enhancing endostatin. 11 This could be considered a theoretical basis for the possible additive effects of these two agents in the management of CNV. Colucciello 6 performed a retrospective noncomparative cases series on 30 eyes with neovascular AMD; all eligible eyes underwent intravitreal injection of 1.25 mg of bevacizumab combined with 2 mg of triamcinolone similar to the protocol used in the IVB/IVT arm of our study.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8] The synergy of angiogenic and inflammatory pathways in the pathogenesis of neovascular AMD suggests that combination treatment may be more effective than monotherapy. [9][10][11] This randomized clinical trial was conducted to compare the efficacy of three consecutive intravitreal bevacizumab (IVB) injections with that of the same regimen combined with intravitreal triamcinolone (IVT) during the initial injection. The three injections were used in a mandated fashion, and retreatment with bevacizumab was only performed if necessary.…”

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confidence: 99%

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Intravitreal Bevacizumab Versus Combined Intravitreal Bevacizumab and Triamcinolone for Neovascular Age-Related Macular Degeneration

Ahmadieh

Taei²,

Riazi‐Esfahani³

et al. 2011

Retina

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Mandated therapy with IVB improved best-corrected visual acuity and decreased central macular thickness in neovascular age-related macular degeneration. The addition of low-dose IVT temporarily increased the therapeutic efficacy in the early postinjection period and resulted in fewer requirements for repeat IVB injections at 6 months; however, final levels of visual improvement were comparable in the 2 study groups.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Intravitreal Bevacizumab Versus Combined Intravitreal Bevacizumab and Triamcinolone for Neovascular Age-Related Macular Degeneration

Ahmadieh

Taei²,

Riazi‐Esfahani³

et al. 2011

Retina

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“…This reduction may explain why some patients stop responding to anti-VEGF-A therapy after a period of time (Tatar et al, 2009). Endothelial sFLT-1 expression is regulated by VEGF, acts as an autocrine regulator of endothelial cell function, and controls angiogenesis (Ahmad et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Photoreceptor avascular privilege is shielded by soluble VEGF receptor-1

Luo

Uehara

Zhang

et al. 2013

eLife

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Optimal phototransduction requires separation of the avascular photoreceptor layer from the adjacent vascularized inner retina and choroid. Breakdown of peri-photoreceptor vascular demarcation leads to retinal angiomatous proliferation or choroidal neovascularization, two variants of vascular invasion of the photoreceptor layer in age-related macular degeneration (AMD), the leading cause of irreversible blindness in industrialized nations. Here we show that sFLT-1, an endogenous inhibitor of vascular endothelial growth factor A (VEGF-A), is synthesized by photoreceptors and retinal pigment epithelium (RPE), and is decreased in human AMD. Suppression of sFLT-1 by antibodies, adeno-associated virus-mediated RNA interference, or Cre/lox-mediated gene ablation either in the photoreceptor layer or RPE frees VEGF-A and abolishes photoreceptor avascularity. These findings help explain the vascular zoning of the retina, which is critical for vision, and advance two transgenic murine models of AMD with spontaneous vascular invasion early in life.DOI: http://dx.doi.org/10.7554/eLife.00324.001

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“…On the other hand, bevacizumab was found to be a more potent angiogenesis inhibitor reducing VEGF expression besides enhancing endostatin. [ 25 ] These findings may explain why IVT added to the combination of PDT and IVB could not demonstrate significant additional benefit in our study.…”

Section: Discussionmentioning

confidence: 78%

Photodynamic therapy and intravitreal bevacizumab with versus without triamcinolone for neovascular age-related macular degeneration; a randomized clinical trial

Piri

Ahmadieh

Taei

et al. 2014

J Ophthalmic Vis Res

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Purpose:To compare the outcomes of photodynamic therapy (PDT) combined with intravitreal bevacizumab (IVB) with versus without intravitreal triamcinolone (IVT) in neovascular age-related macular degeneration (AMD).Methods:Eighty-four eyes with active CNV secondary to AMD with no prior treatment were enrolled and followed for 1-year. Eligible eyes were randomly assigned to either PDT/IVB or PDT/IVB/IVT. The main outcome measure was change in best-corrected visual acuity (BCVA).Results:Mean patient age was 71 ± 9 years. BCVA changes from baseline were statistically significant in both study arms at all follow-up intervals, however no significant difference was observed between the two groups regarding BCVA changes at week 12 (95% CI:-0.11–0.12 LogMAR) and other time points (all P > 0.6). Mixed model analysis revealed a significant effect from age (P < 0.001), pigment epithelial detachment (P = 0.009) and baseline BCVA (P < 0.001) on visual improvement. Significant central macular thickness (CMT) reduction occurred at all-time points as compared to baseline in both groups which was comparable between the study arms. There was no significant difference between the study arms in terms of retreatment rate (P = 0.1) and survival to the first repeat IVB injection (P = 0.065).Conclusion:Additional low-dose IVT to a PDT/IVB regimen for neovascular AMD provided no beneficial effects in terms BCVA or CMT, yet demonstrated a trend toward extending the injection-free period.

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Implications of bevacizumab on vascular endothelial growth factor and endostatin in human choroidal neovascularisation

Abstract: A shift within the angiogenic balance in terms of decreased VEGF predominance over endostatin is detected in human CNV treated with bevacizumab.

Cited by 9 publications

References 46 publications

Intravitreal Bevacizumab Versus Combined Intravitreal Bevacizumab and Triamcinolone for Neovascular Age-Related Macular Degeneration

Intravitreal Bevacizumab Versus Combined Intravitreal Bevacizumab and Triamcinolone for Neovascular Age-Related Macular Degeneration

Photoreceptor avascular privilege is shielded by soluble VEGF receptor-1

Photodynamic therapy and intravitreal bevacizumab with versus without triamcinolone for neovascular age-related macular degeneration; a randomized clinical trial

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