Intravitreal bevacizumab (Avastin®) in proliferative diabetic retinopathy

• Published in: Acta ophthalmologica (Oxford, England) England), 2008-09, Vol.86 (6), p.683-687
• Main Authors: Minnella, Angelo M., Savastano, Cristina M., Ziccardi, Lucia, Scupola, Andrea, Sasso, Paola, Falsini, Benedetto, Balestrazzi, Emilio
• Format: Article
• Language: English
• Subjects: Adult; Aged; Angiogenesis Inhibitors - adverse effects; Angiogenesis Inhibitors - therapeutic use; Antibodies, Monoclonal - adverse effects; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized; Bevacizumab; Diabetic Retinopathy - diagnosis; Diabetic Retinopathy - drug therapy; Female; Fluorescein Angiography; Humans; Injections; Male; Middle Aged; panretinal laser photocoagulation; proliferative diabetic retinopathy; Recurrence; Retinal Neovascularization - diagnosis; Retinal Neovascularization - drug therapy; Retreatment; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Vitreous Body; vitreous haemorrhage; Vitreous Hemorrhage - diagnosis; Vitreous Hemorrhage - drug therapy
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1600-0420.2007.01042.x

. Purpose:  To evaluate the efficacy and safety of intravitreal bevacizumab in proliferative diabetic retinopathy (PDR) patients. Methods:  This interventional case series study included 15 eyes of 10 patients with bilateral PDR: 13 eyes with severe PDR and active new vessels (NV) and two eyes with recurrent vitreous haemorrhages. Study eyes received a single intravitreal injection of 1.25 mg (0.05 ml) bevacizumab. All eyes were followed up for 3 months, and eight of them for 9 months. Reinjection was performed in three eyes 4–6 months after the first injection. Study eyes were evaluated by fluorescein angiography at baseline, 1, 3 and 9 months. Quantitative planimetric analysis (QPA) of NV area was measured before and after treatment. All eyes received or completed panretinal photocoagulation (PRP) 1 month after the first injection. Results:  As early as at 1 month, all study eyes had a regression (paired t‐test, P = 0.01) of QPA‐estimated NV area. The eyes with recurrent vitreous haemorrhages had clearing of bleeding. These early effects were maintained at 3 months for all eyes and tended to be stable at 9 months. The fast and measurable efficacy of bevacizumab allowed a subsequent complete and safe PRP. Conclusion:  Intravitreal bevacizumab did not reveal any side‐effects and was effective in the regression of NV areas and the resolution of vitreous haemorrhages. This approach is potentially useful in allowing (within a planned temporal window) a safe and efficient PRP to be performed while minimizing the risk of its complications.