Intravitreal Injection of Bevacizumab (Avastin) as Adjunctive Treatment of Proliferative Diabetic Retinopathy

Mason, John O.; Nixon, Peter A.; White, Milton F.

doi:10.1016/j.ajo.2006.04.058

Cited by 138 publications

(90 citation statements)

References 5 publications

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“…7,13 In addition, there are five case reports on the use of intravitreal bevacizumab in RN in diabetic retinopathy demonstrating regression of RN in PDR. 14,[29][30][31][32] Our study demonstrated that intravitreal bevacizumab resulted in marked regression of RN on fundus examination and FA in patients with PDR and previous PRP. Furthermore, a rapid resolution of vitreous haemorrhage in three naive eyes was also seen.…”

Section: Discussionsupporting

confidence: 51%

“…9 Recent studies have demonstrated the usefulness of an intravitreal injection of bevacizumab in the reduction of vascular permeability and fibrovascular proliferation in macular oedema secondary to central vein occlusion, RN secondary to PDR, and choroidal neovascularization secondary to age macular degeneration. 8,[10][11][12][13][14] The amount of human retinal penetration for a complete full-length anti-VEGF antibody is not known at present. However, full thickness retinal penetration of intravitreal bevacizumab was observed in an animal model.…”

Section: Introductionmentioning

confidence: 99%

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Intravitreal bevacizumab (avastin) for proliferative diabetic retinopathy: 6-months follow-up

Arévalo¹,

Sánchez³

et al. 2007

Eye

118

101

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Aims To study the effects of intravitreal bevacizumab (Avastin) on retinal neovascularization (RN) in patients with proliferative diabetic retinopathy (PDR). Methods Retrospective study of patients with RN due to PDR who were treated with at least one intravitreal injection of 1.25 or 2.5 mg of bevacizumab. Patients underwent ETDRS best-corrected visual acuity (BCVA) testing, ophthalmoscopic examination, optical coherence tomography (OCT), and fluorescein angiography (FA) at baseline and follow-up visits.Results Forty-four eyes of 33 patients with PDR and a mean age of 57.2-years (range: 23-82 years) participated in the study. Thirty-three eyes (75%) had previous panretinal photocoagulation (PRP). Twenty-seven eyes (61.4%) showed total regression of RN on fundus examination with absence of fluorescein leakage, 15 eyes (34.1%) demonstrated partial regression of RN on fundus examination and FA. Follow-up had a mean of 28.4 weeks (range from 24 to 40 weeks). BCVA and OCT demonstrated improvement (Po0.0001). Three eyes without previous PRP ('naive' eyes) and with vitreous haemorrhage have avoided vitreo-retinal surgery. One eye (2.2%) had PDR progression to tractional retinal detachment requiring vitrectomy, and one eye (2.2%) had vitreous haemorrhage with increased intraocular pressure (ghost cell glaucoma). No systemic adverse events were observed. Conclusions Intravitreal bevacizumab resulted in marked regression of RN in patients with PDR and previous PRP, and rapid resolution of vitreous haemorrhage in three naive eyes. Six-months results of intravitreal bevacizumab at doses of 1.25 or 2.5 mg in patients with PDR do not reveal any safety concerns.

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Section: Discussionsupporting

confidence: 51%

Section: Introductionmentioning

confidence: 99%

Intravitreal bevacizumab (avastin) for proliferative diabetic retinopathy: 6-months follow-up

Arévalo¹,

Sánchez³

et al. 2007

Eye

118

101

View full text Add to dashboard Cite

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“…Bevacizumab, a vascular endothelial growth factor antibody, induces regression of the vascular component of the fibrovascular membranes (FVMs). [3][4][5] This facilitates segmentation and delamination of membranes, as they are less adhesive to the underlying retina and are more readily separated. 6 IVB has also been shown to decrease intraoperative haemorrhage.…”

Section: Introductionmentioning

confidence: 99%

Bevacizumab as an adjunct to vitreoretinal surgery for diabetic retinopathy in East Africa

Guthrie

Hall

Dhalla

et al. 2013

Eye

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Purpose The purpose of this study is to evaluate the efficacy of preoperative intravitreal bevacizumab (IVB) for improving outcomes in vitrectomy for diabetic retinopathy-related non-clearing vitreous haemorrhage and/or tractional retinal detachment. Methods Medical record from patients undergoing vitrectomy for proliferative diabetic retinopathy (PDR) were retrospectively analysed (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011). From 2007, IVB (1.25 mg 2-4 days before operating) was used on all eyes. Eyes receiving IVB were compared with those that did not receive IVB. Intraoperative complications, reoperation rates, and final visual acuity were the core outcome measures. Results Data were analysed for 88 patients (101 eyes). In all, 41 (41%) patients had received IVB, whereas 60 (59%) patients had not. Significant intraoperative haemorrhage occurred in six eyes (10%) in the non-IVB group and in one (2.4%) IVB eyes (P ¼ 0.24). Silicon oil was used in 29 (48%) non-IVB eyes and in 11 (27%) IVB eyes (P ¼ 0.03). The non-IVB eyes underwent significantly more vitreoretinal reoperations (P ¼ 0.01) and were significantly more likely to lose two or more lines of vision at the final follow-up (P ¼ 0.03). The numbers needed to treat (NNT) blindness (o3/60) was four for non-IVB eyes and two for the IVB group. Conclusions IVB reduces surgical complications, the use of silicon oil, and the need for further retinal surgery. The NNT to restore useful vision (Z3/60) to a blind eye were significantly lower in the IVB group. Vitreoretinal surgery for the complications of PDR is effective in an East African context, and IVB should be considered a valuable adjunct.

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“…Bevacizumab, however, has been widely used off-label in the treatment of PDR [716][717][718] , iris new vessels 719;720 , and DME [721][722][723][724] , because of its relative low cost. Non-comparative studies show some efficacy in the treatment of these three conditions (Level III-3 evidence).…”

Section: Intravitreal Vascular Endothelial Growth Factor (Vegf) Inhibmentioning

confidence: 99%

Adherence to diabetic eye examination guidelines in Australia: the National Eye Health Survey

Foreman

Keel

Xie

et al. 2017

Medical Journal of Australia

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Intravitreal Injection of Bevacizumab (Avastin) as Adjunctive Treatment of Proliferative Diabetic Retinopathy

Cited by 138 publications

References 5 publications

Intravitreal bevacizumab (avastin) for proliferative diabetic retinopathy: 6-months follow-up

Intravitreal bevacizumab (avastin) for proliferative diabetic retinopathy: 6-months follow-up

Bevacizumab as an adjunct to vitreoretinal surgery for diabetic retinopathy in East Africa

Adherence to diabetic eye examination guidelines in Australia: the National Eye Health Survey

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