Vitreous Levels of Unbound Bevacizumab and Unbound Vascular Endothelial Growth Factor in Two Patients

Beer, Paul M.; Wong, Susan J.; Hammad, Amjad M; Falk, Naomi S.; O’Malley, Martin R.; Khan, Samira

doi:10.1097/01.iae.0000233327.68433.02

Cited by 110 publications

(83 citation statements)

References 7 publications

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“…However, bevacizumab, although rapidly-acting, induces temporary antiangiogenic effects with recurrence of neovascularization, 28,33 due to its short duration of action. 34,35 On the other hand, the effects of PRP appear to be more long lasting, suggesting that eyes with NVG can benefit from both the early-onset Figure 1 (a) Kaplan-Meier Survival Analysis of NVG Eyes Receiving GDIs. The figure shows that cumulative proportion of eyes receiving a GDI over time from NVG diagnosis in the bevacizumab group was lower compared with the non-bevacizumab group within the first 6 months.…”

Section: Discussionmentioning

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: Discussionmentioning

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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“…An intravitreal injection of 1.25 mg bevacizumab was followed by planned vitrectomy after 3-30 days. 10 …”

Section: Methodsmentioning

confidence: 99%

Preferable use of intravitreal bevacizumab as a pretreatment of vitrectomy for severe proliferative diabetic retinopathy

Ishikawa

Honda

Tsukahara

et al. 2007

Eye

104

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Purpose To evaluate the safety and efficacy of intravitreal injection of bevacizumab advanced to vitrectomy for severe proliferative diabetic retinopathy. Methods Eight eyes of six patients (33-64 years old, all male patients) with severe proliferative diabetic retinopathy were investigated. An intravitreal injection of 1.25 mg bevacizumab was performed 3-30 days prior to planned vitrectomy. Results All cases showed minimum bleeding during surgical dissection of fibrovascular membrane. Two cases receiving bevacizumab 7 days before the surgery showed strong fibrosis and adhesion of fibrovascular membrane, resulted in some surgical complications. The cases having intravitreal bevacizumab for shorter time did not show extensive fibrosis. Conclusions The pretreatment of bevacizumab is likely effective in the vitrectomy for severe PDR. The appropriate timing of vitrectomy after bevacizumab injection should be further evaluated.

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“…A single administration of an arbitrary dose based on the intravi treal preparation of bevacizumab may be inadequate. A single dose of 1.25 mg of intravitreal bevacizumab has been reported to provide complete intravitreal VEGF blockade for a minimum of 4 weeks, with an intravitreal bevacizumab halflife of approximately 3 days (28) . Ho wever, the conjunctival halflife of the drug may be shorter than the vitreous halflife because of the higher systemic absorption through the abundant conjunctival vessels (24) .…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of subconjunctival bevacizumab for recurrent pterygium

Stival¹,

Lago²,

Figueiredo³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Purpose: To evaluate the clinical outcome(s) and complication(s) of subcon junctival bevacizumab treatment in patients with recurrent pterygium. Methods: This prospective case series included patients who had undergone pterygium surgery and were diagnosed with recurrent pterygium. All patients received one subconjunctival injection of 0.5 mL of bevacizumab (2.5 mg/0.1 mL). The main outcome was the change in size and clinical appearance. The clinical appearance of the pterygium was graded according to Tan and colleagues. The horizontal size of the pterygium (from limbus to apex) was recorded from baseline to 2 months after injection. Treatmentrelated complications and adverse events were reported. Results: We included 36 eyes of 36 patients (18 males) with a mean age of 58.75 ± 10.98 years. Totally, 30.6% patients developed recurrent pterygium in both eyes (only the worst eye was treated), with 47.2% developing it in the left eye and 22.2% in the right eye. More than half the patients (58.3%) had a family history of pterygium. There was a significant difference in the size of pterygium at different intervals (P<0.05). Approximately twothirds (66.7%) of patients pre sented with hyposphagma on the 2 nd day after subconjunctival application; this value decreased to 30.6% by day 7 and to 0% at 1 month. Most patients (69.4%) ex hibited amelioration of irritative symptoms within 2 days, 88.9% after 7 days, and 97.2% after 1 month. Conclusions: Subconjunctival bevacizumab injection is useful for the manage ment of patients with recurrent pterygium, with no significant local or systemic adverse effects.

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Vitreous Levels of Unbound Bevacizumab and Unbound Vascular Endothelial Growth Factor in Two Patients

Abstract: A single dose of intravitreal bevacizumab is likely to provide complete intravitreal VEGF blockade for a minimum of 4 weeks, with an intravitreal bevacizumab half-life of approximately 3 days.

Cited by 110 publications

References 7 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

Preferable use of intravitreal bevacizumab as a pretreatment of vitrectomy for severe proliferative diabetic retinopathy

Efficacy and safety of subconjunctival bevacizumab for recurrent pterygium

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