Effects of intravitreal bevacizumab injection on the clinical manifestations of nonproliferative diabetic retinopathy in patients with macular edema: a systematic review

Introduction: Bevacizumab [Avastin] is considered as an effective strategy in the treatment of various ocular diseases. As a vascular endothelial growth factor [VEGF] inhibitor, Avastin is used to control macular edema in patients with nonproliferative diabetic retinopathy [NPDR]. Therefore, in this study, we systematically reviewed the effects of intravitreal bevacizumab injections on nonproliferative stage of diabetic retinopathy

Methods: Scopus and PubMed were systematically searched to find articles in which the effect of Avastin [bevacizumab] had been evaluated in nonproliferative stage of diabetic retinopathy. Literature search was performed using "Avastin OR bevacizumab", "nonproliferative stage" and "diabetic retinopathy" as keyterms in the title, keywords, and abstract

Result: All 47 articles were found in all databases, two additional records were found through reference list screening, and only 10 articles were relevant to the purpose of this study. According to the inclusion/exclusion criteria, 39 articles were excluded in several step processes of article selection. The results revealed that intravitreal injection of bevacizumab could be safely used to treat various ocular disease, particularly NPDR stage of diabetic retinopathy with macular edema

Discussion: Bevacizumab is considered as a novel and effective modality in the treatment of various ocular diseases such as retinal neovascularization, neovascular glaucoma, macular edema, and other ocular complications. Findings also suggested that bevacizumab is a suitable therapeutic approach in clinical use

Conclusion: According to the results of included documents, intravitreal injection of bevacizumab could be considered as a promising treatment modality in the clinical management of NPDR stage of diabetic retinopathy

Iontophoresis in ophthalmology: a review of the literature

Drug delivery to the inner part of the eye is still a problem in treatmentof ocular disease. Iontophoresis has been used in the field of medicine formany years. This technique consists of applying a weak electrical currentto drive charged drug molecules across tissue barriers. Transcornealiontophoresisdelivers a high concentration of drug to the anteriorsegment of the eye [cornea, aqueous humor, ciliary body, iris, and lens],for the treatment of anterior segment diseases. There are different types ofiontophoresis such as ophthalmic, transdermal, transungual, oral, buccal,and transnasal. The benefit of iontophoretic drug delivery in ophthalmologylays in its capacity to provide high drug tissue concentration safely,while minimizing the systemic drug exposure. This review summarizesbasics of ocular iontophoresis and iontophoretic device, trans cornealand transscleraliontophoresis, and the applications of iontophoresis inophthalmology

Short-term intraocular pressure changes after intravitreal bevacizumab injection

Intravitreal injections of anti-vascular endothelial growth factors [antiVEGFs] have become more popular quickly in recent years. Bevacizumab is an anti- vascular endothelial growth factor agent [anti-VEGF] used to treat choroidal neovascularization and retinal vascular disorders. Rare long lasting ocular adverse events are reported in the intravitreal injection of this drug that include intraocular inflammation, retinal tears, vitreous hemorrhage, endophtalmitis, and lens changes. One important concern about intravitreal injection of anti-VEGF drug is intraocular pressure [IOP] elevation. There are two kinds of IOP elevation. First one is an acute elevation of IOP [after few minutes] and the second is delayed IOP elevation [after few months]. The prevalence of IOP elevation immediately after injection is significantly high and seems to have the potential risk for optic nerve fiber loss results in decreased vision but fortunately this IOP elevation seems to be transient in most of studies

[Evaluation of relationship between contrast sensitivity, color vision and visual acuity in diabetic patients with and without retinopathy]

To investigate the discriminative ability of contrast sensitivity [CS], color vision and log MAR visual acuity [VA] in detecting functional losses in diabetic participants with and without retinopathy comparing to the control group. In this cross sectional study in 1388 we examined 105 patients in Mashhad Khatam- Al-Anbia Eye Hospital including 70 diabetic patients [35 with retinopathy and 35 without retinopathy] with 35 control group. Contrast sensitivity was examined by means of CSV-1000 E at 3, 6, 12 and 18 cpd respectively. Color discrimination ability was measured with the Farnsworth D-15 test and log MAR VA by Snellen chart. Contrast sensitivity was significantly lower in the diabetic eyes with retinopathy than in the normal eyes in all spatial frequencies. Comparing to the control group, there was a statistically significant CS loss in spatial frequencies of 3, 6, 18 cpd in the diabetic eyes without retinopathy [p<0.05]. The mean log MAR VA and color vision abnormalities were significantly higher in the diabetic eyes with retinopathy than in the normal eyes or the diabetic eyes without retinopathy [p<0.001]. The sensitivity and specificity of the CS test in 6 cpd were 71% and 82% which were significantly higher than other spatial frequencies. The sensitivity and the specificity of the color vision test and VA [log MAR >/= 0.05, Snellen