Efficacy of intravitreal bevacizumab (Avastin) for short-term treatment of diabetic macular edema.

Efficacy of intravitreal bevacizumab (Avastin) for short-term treatment of diabetic macular edema.
Nagasawa T, Naito T, Matsushita S, Sato H, Katome T, Shiota H.
Department of Ophthalmology, Institute of Health Biosciences, the University of Tokushima Graduate School, Tokushima, Japan.

PURPOSE: To report the efficacy of intravitreal injections of bevacizumab for diabetic macular edema (DME) in the short-term.

DESIGN: Retrospective, noncomparative, interventional case series.

METHODS: Medical records of 20 eyes of 19 patients who underwent intravitreal injections of bevacizumab for persistent diabetic macular edema were reviewed retrospectively. All eyes received intravitreal injections of bevacizumab (1.25 mg/0.05 ml). The clinical course of best-corrected visual acuity (BCVA) using a logarithm of the minimum angle of resolution chart, and averaged foveal retinal thickness using an optical coherence tomography (OCT) were monitored for up to four weeks after the injection.

RESULTS: BCVA at one week improved by two lines or more in six eyes (30%) and in nine eyes (45%) at four weeks. However, no significant improvement in the mean BCVA from baseline was observed at one week (P>0.05) and four weeks (P>0.05). Mean retinal thicknesses (RT) were 411+/-170 mum at baseline, 349+/-102 microm at one week after the injection (P<0.05),>0.05). One week after the injection, significant regression of macular edema was seen. However, recurrence occurred at four weeks. No complications such as severe vision loss, endophthalmitis, or systemic events developed.

CONCLUSION: No changes in BCVA and RT were observed in the short-term observation after the intravitreal injection of bevacizumab for DME.

Journal of Medical Investigation

Bevacizumab improved vision, macular edema in study of RVO patients

Bevacizumab improved vision, macular edema in study of RVO patients

OSN SuperSite Breaking News 10/24/2007

Bevacizumab improved visual acuity and central macular edema symptoms in patients with retinal vein occlusion within 9 weeks after treatment, according to a prospective study by researchers in Germany.

Andreas Stahl, MD, and colleagues at University of Freiburg evaluated the 9-week responses to a single injection of Avastin (bevacizumab, Genentech) in 14 central retinal vein occlusion (RVO) patients and seven branch RVO patients.

At follow-up, the researchers found that mean visual acuity for the 21 patients had increased an average of 2.4 lines (P < .01) over baseline. Also, the improvement in visual acuity was in concert with a decrease in central retinal thickness, according to the study.

The best improvement in visual acuity was reached between 3 and 6 weeks post-injection and began to decrease from 6 to 9 weeks, the authors noted.

"This [visual acuity] decrease was precipitated by an increase in [central macular edema] between week 3 and 6," they said.

In subgroup analyses, patients who received a bevacizumab injection within the first 3 months of RVO showed an average four-line gain in vision, compared with an average gain of 1.8 lines in patients treated between 4 and 6 months after RVO and a gain of 2.5 lines for those treated later than 6 months after RVO onset, according to the study.

"We did not observe any short-term adverse effects during our study," the authors noted.

The study is published in the October issue of Graefe's Archive for Clinical and Experimental Ophthalmology.

Bevacizumab and the treatment of macular edema

Bevacizumab for the treatment of macular edema secondary to retinal vein occlusion

Ophthalmologe. 2007 Mar 20
Schaal KB,
Hoh AE,
Scheuerle A,
Schutt F,
Dithmar S.
Schwerpunkt Retinologie, Universitatsaugenklinik Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland, stefan.dithmar@med.uni-heidelberg.de.

BACKGROUND: Retinal vein occlusion often leads to macular edema as a result of an elevated level of intravitreal VEGF. We report on the anatomic and functional results after intravitreal bevacizumab injections in patients with retinal vein occlusion.

METHODS: In a prospective study, 18 patients with central, and 22 patients with branch retinal vein occlusion, all of whom had persistent macular edema (>300 mum) received 2.5 mg intravitreal bevacizumab. ETDRS visual acuity, ophthalmic examination and stratus OCT were performed at baseline, 1 week after injection and then monthly. Further injections were given every 6 weeks in patients with persistent or recurring macular edema.

RESULTS: The findings did not deteriorate in any of the 40 patients. The injections (mean of 2.6+/-1.4 injections/patient) were very well tolerated in all cases during a mean follow-up of 23+/-13 weeks. On the last visit, 73.3% of patients with central retinal vein occlusion and 76.5% of those with branch retinal vein occlusion were found to have significantly improved visual acuity (by at least 3 lines). Mean central retinal thickness had decreased from 921+/-264 to 239+/-66.2 mum in patients with central retinal vein occlusion, and from 678+/-221 to 236+/-78 mum in patients with branch retinal vein occlusion.

CONCLUSIONS: Neither intraocular nor systemic side-effects were observed in this study after repeated intravitreal injections of 2.5 mg bevacizumab. Current results suggest that intravitreal anti-VEGF therapy is a promising option in macular edema secondary to retinal vein occlusion.

PMID: 17372737 [PubMed - as supplied by publisher]