Response to anti-vascular endothelial growth factor of abnormal retinal vascular net in para foveal telangiectasia group II images on optical coherence tomography-angiography

Purpose: To identify optical coherence tomography-angiography (OCT-A) findings to predict treatment response during anti-vascular endothelial growth factor (VEGF) therapy in eyes with para foveal telangiectasia (PFT) group II. Methods: In this retrospective series, Twelve eyes of seven patients diagnosed with PFT group II without evidence of sub-retinal neovascular membrane (SRNVM) clinically or on spectral domain-OCT (SD-OCT) were included. All patients underwent OCT-A on the Topcon DRI OCT Triton® with 4.5 mm macula scans. The patients with abnormal vascular nets were further classified into type A and B nets and administered intravitreal anti-VEGF therapy. Visual acuity and size of type A and B nets were evaluated pre- and post-injection. Paired t- test and intraclass correlation were used to analyse data. Results: Patients with type A net showed significant improvement in visual acuity (logMAR 0.38, P = 0.0047). The size of type A net showed statistically significant decrease (P = 0.0008) on 6 month follow up. Type B net did not show statistically significant difference in visual acuity or size following anti-VEGF therapy. Conclusion: OCT-A plays an important role in early detection of possible neovascular nets (type A), in the absence of obvious SRNVM. Treatment decisions based on OCT-A may be helpful to achieve better visual outcome.

A study on the contamination of injection bevacizumab on storage of multidose vials

Purpose: The aim of this study is to establish the safety of storage and reuse of bevacizumab vials for 1 week with multiple vial punctures. Methods: This was an experimental microbiological study conducted at tertiary care hospital. The study samples included bevacizumab vials that had been used for injecting patients by the pooling method. Vials were stored and sampled in a manner that replicated their proposed clinical use. Contamination of vials was evaluated on the basis of microbial culture and validated by positive and negative controls. The probability of obtaining such results purely by chance was calculated. Results: A total of 210 samples from 30 vials were evaluated along with 210 positive and 210 negative controls. No growth was seen in any of the bevacizumab samples. The probability of obtaining 210 consecutive sterile samples just by chance is <5.547 � 10?6 (0.000005547). Conclusion: The vials showed no contamination on storage for 7 days in an ordinary refrigerator. Thus, we conclude that the rate of contamination of bevacizumab vials on storage for 7 days in a refrigerator is likely to be insignificant. The results need to be validated by other studies replicating this protocol.

OUTCOME OF ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION / Шинэ санаа Шинэ нээлт

@#BACKGROUND: There are two general types of age-related macular degeneration: dry and wet. During wet or neovascular age-related macular degeneration new abnormal vessels grow and leak in the macula. As anti-vascular endothelial growth factor (anti-VEGF) was invented, it revolutionized the treatment of nAMD by inhibiting the progress of this disease. The incidence of AMD increases as life expectancy grows and there is a growing need to study this disease. We aimed to evaluate the outcome of anti-VEGF therapy for the treatment of nAMD and the incidence of ocular serious adverse events (SAE) after injections.. METHODS: In our retrospective, single-center study, medical records of patients receiving a single dose of anti-VEGF treatment (Bevacizumab) for nAMD between 17th of April, 2016 and October, 2017 were evaluated. Outcome measures were the change in the baseline visual acuity (VA) score at post-injective month one, incidence of ocular SAE and patients’ baseline characteristics affecting VA. Patients, whose treatment were started before April 2016 and had anti-VEGF treatment for the diseases other than nAMD, were excluded.. RESULTS: 15 eyes in 15 patients between 52 and 85 years of age received single dose of anti-VEGF (Bevacizumab/Avastin) injection. The mean baseline VA improved from pre-injective average of 0.21 to post-injective 1-month average of 0.37 by Snellen. Furthermore, there was no vision loss or other severe adverse effects, such as endophthalmitis, vitreous hemorrhage, retinal detachment, traumatic cataract after 4 weeks. CONCLUSION: Anti-vascular endothelial growth factor therapy has promising short-term outcomes on treating neovascular age-related macular degeneration.

Revisión con agujas y uso de bevacizumab en bulas de filtración encapsuladas / Needle revision and the use of bevacizumab in encapsulated filtration blebs

Objetivo: determinar la efectividad a mediano plazo de la revisión con aguja asociada a bevacizumab (avastin) en ampollas de filtración encapsuladas postrabeculectomía. Métodos: se realizó un estudio observacional descriptivo-prospectivo, de serie de casos (14 ojos, 14 pacientes), con antecedentes de quiste de Tenon a corto plazo postrabeculectomía (2 meses - 1 año). Se realizó revisión con aguja asociada a inyección subconjuntival de avastin (1 mg) hasta completar 3 dosis en días alternos. Se evaluaron la presión intraocular y el uso de colirios hipotensores preoperatorio y posoperatorio a la semana, 1 mes, 3 meses y 1 año. Se definió el éxito total (si en el posoperatorio la PIO era menor o igual a 21 mmHg sin necesidad de colirios hipotensores); parcial (si la PIO era menor o igual a 21 mmHg con el uso de hasta dos fármacos); y sin éxito (si la PIO era menor o igual a 21 mmHg con 3 colirios hipotensores o mayor que 21 mmHg). Se registraron las complicaciones quirúrgicas. Resultados: la edad media fue de 59,3 ± 8,4 (43-75). Predominó el sexo femenino (57 por ciento) y no existieron diferencias en cuanto al color de piel (7/7). El grado de reducción de la PIO fue regular a la semana y al mes, y malo a los 3 meses y al año, lo que requirió una nueva cirugía en 11 casos (78,6 por ciento). Las complicaciones más frecuentes fueron: hemorragia subconjuntival (71,4 por ciento de casos) y Seidel positivo (21,4 por ciento). Conclusiones: la revisión con aguja asociada al uso de avastin subconjuntival como tratamiento de la ampolla encapsulada no logra una reducción significativa de la presión intraocular(AU)

Objective: determine the medium-term effectiveness of needle revision with bevacizumab (avastin) in encapsulated filtration blebs after trabeculectomy. Methods: an observational descriptive prospective case-series study was conducted of 14 eyes of 14 patients with a history of Tenon cyst shortly (2 months - 1 year) after trabeculectomy. Needle revision was performed by avastin subconjunctival injection (1 mg) until completing 3 doses on alternate days. Evaluation of intraocular pressure and the use of hypotensive collyriums before and after surgery was conducted at 1 week, 1 month, 3 months and 1 year. Definitions were made of total success (IOP minor or equal 21 mmHg in the postoperative period without hypotensive collyriums), partial success (IOP minor or equal 21 mmHg with up to two drugs), and no success (IOP minor or equal 21 mmHg with 3 hypotensive collyriums or greater than 21 mmHg). Surgical complications were recorded. Results: mean age was 59.3 ± 8.4 (43-75) years. Female sex prevailed (57 percent) and no differences were found based on skin color (7/7). The degree of IOP reduction was fair at one week and one month, and bad at 3 months and one year, 11 cases (78.6 percent) requiring new surgery. The most common complications were subconjunctival hemorrhage (71.4 percent of the cases) and positive Seidel (21.4 percent). Conclusions: needle revision with subconjunctival avastin to treat encapsulated blebs does not achieve a significant reduction in intraocular pressure(AU)

An unusual presentation of nonarteritic ischemic optic neuropathy with subretinal fluid treated with intravitreal bevacizumab.

A 62‑year‑old hypertensive male presented with acute nonarteritic ischemic optic neuropathy (NAION) with contiguous macular edema and subretinal fluid in the right eye. Presenting vision was 20/1000. The patient was treated with intravitreal bevacizumab 1.25 mg/0.05 ml. At 1 month follow‑up, the macular edema and the optic nerve head edema completely resolved with a good visual improvement up to 20/40. The visual improvement was maintained at the last follow‑up 6 months postinjection. Intravitreal bevacizumab may be a good option for acute NAION especially in an unusual presentation with macular edema and subretinal fluid.

Antitumor effects of peptide HM-3 against non-small cell lung cancer xenografts in nude mice / 中国药理学通报

Aims Toevaluatethepharmacodynamic efficacy of different types of antiangiogenic agents as HM-3 on a non-small cell lung cancer xenografts tumor model .To explore the interaction between the antian-giogenic agents and the tumor microenvironment,and to offer suggestions for clinical therapy.Methods Thenon-smallcelllungcarcinomaxenograftmodelwas established in Balb/c nude mice.The model mice were treated with Docetaxel(10 mg·kg-1 )as the positive control.The mice were parallelly treated with,HM-3 at the doses of 3 mg · kg-1 and 48 mg · kg-1 and, Avastin(5 mg·kg-1 ).The parameters include tumor volume,tumor weight and immunohistochemical analy-sis.Result Animalexperimentsshowedthatdocetaxel had good anti-tumor activity.Tumor growth inhibition by tumor weight of G2 docetaxel(10 mg·kg-1 )group was 60. 80%.Tumor growth inhibition by tumor weight of G3 HM-3(3 mg·kg-1 )group,G4 HM-3(48 mg· kg-1 )group ,G4 Avastin(5 mg·kg-1 )group,were 43. 60%,-34. 80%,44. 40%,respectively.Con-clusion Theantigiogeniceffectisaffectedbytumor growth stage,tumor microenvironment and their work-ing mechanisms.Angiogenesis inhibitors HM-3 has a certain effect of inhibiting tumor growth,but to little a-vail.HM-3 shows on inhibitory effect in a dose-de-pendent manner at the doses of 0~6 mg·kg-1 .HM-3 at a high dose of 48 mg · kg-1 has no inhibitory but promoting effects on human non-small cell lung carci-noma A549 xenografts in nude mice .Special dose-effect relationship indicates that dosage should be paid attention to in the clinical use of blood vessel inhibi-tors.

Uso de bevacizumab (avastin) sublesional en papilomatosis laríngea recurrente / Sublesional use of bevacizumab (avastin) in recurrent laryngeal papillomatosis

La papilomatosis laríngea recurrente es una enfermedad producida por el virus del papiloma humano, que produce lesiones epiteliales exofíticas. En la actualidad, no existe un tratamiento definitivo, existiendo una gran recurrencia de las lesiones. Una de las alternativas promisorias es el uso de láser KTP con bevacizumab. No obstante, en nuestro medio, los hospitales no cuentan con láser KTP, utilizándose únicamente técnica en frío. Se presenta un caso clínico de papilomatosis laríngea recurrente con el uso de bevacizumab (avastin) a 16,5 mg/mL como terapia adyuvante a cirugía con técnica en frío.

Recurrent laryngeal papillomatosis is a disease caused by the human papillomavirus that causes exophytic epithelial lesions. Currently, there is no definitive treatment, existing high recurrence of lesions. One of the promising alternatives is the use of KTP laser with bevacizumab. However, in our hospitals we do not have KTP, but only cold excision. We present a case of recurrent laryngeal papillomatosis treated with intralesional injections of bevacizumab (avastin) 16.5 mg/mL as adjuvant therapy to cold excision.

Revisión con aguja tras implante de válvula de Ahmed en la ciclitis heterocrómica de Fuchs / Needle revision after Ahmed valve implantation in the management of Fuch´s heterochromic cyclitis

La ciclitis heterocrómica de Fuchs es una uveítis crónica que puede ser asintomática por años o expresar solo la heterocromía antes que aparezca cualquier otro signo. El glaucoma se considera una de las complicaciones más difíciles de tratar, y requiere cirugía en múltiples ocasiones. Los dispositivos de drenaje están siendo cada vez más utilizados como alternativa de tratamiento quirúrgico en estos casos. Asiste a la consulta médica una paciente de 36 años de edad, con antecedentes de uveítis crónica unilateral del ojo izquierdo asociado a catarata y glaucoma descompensado, a pesar del tratamiento médico. Se presenta con 50 VAR de visión y presión intraocular de 32 mmHg. Se realizó cirugía combinada: facoemulsificación e implante de válvula Ahmed modelo S2 con mitomicina C (0,2 mg/mL) durante cinco minutos. Se diagnostica ampolla de filtración encapsulada en la octava semana. Se realiza revisión con aguja y subconjuntival de 1 mg de bevacizumab (avastin) subtenoniano en área de la filtrante. La inyección se repite días alternos hasta completar tres dosis según protocolo institucional. Se logran cifras de presión intraocular de 17 mmHg y agudeza visual mejor corregida de 95 VAR a los 18 meses posoperatorios(AU)

Fuch´s heterochromic cyclitis is chronic uveitis that may be asymptomatic for years or may express heretochromia just before the onset of any other sign. Glaucoma is considered one of the most difficult complications to be treated and requires multiple surgeries. Drainage devices are increasingly used as a surgical treatment option in these cases. Here is the case of a 36 years-old woman with a history of unilateral chronic uveitis in her left eye associated to cataract and decompensate glaucoma despite the medical therapy. She presented with 50 VAR visual acuity and 32 mmHg intraocular pressure. She underwent combined surgery based on phacoemulsification and S2 model Ahmed valve implantation with mitomycin C (0,2 mg/mL) for 5 minutes. The diagnosis was encapsulated filtering bleb at the 8th week of operation. Subconjuctival needle revision with one mg of subtenial bevacizumab (avastin) in the bleb area was performed. Injection was administered every other day till completion of three doses according to the institutional protocol. Eighteen months after the surgery, the intraocular pressure was 17nnHg and the best corrected visual acuity reached 95 VAR best corrected visual acuity(AU)

Inyección intravítrea de bevacizumab vs. acetato de triamcinolona en el edema macular secundario a oclusión de rama venosa retiniana / Intravitreal bevacizumab vs. triamcinolone acetonide injection to treat macular edema secondary to branch retinal vein occlusion

Objetivo: comparar los resultados del tratamiento intravítreo de bevacizumab y de acetato de triamcinolona en el edema macular secundario ante la oclusión de rama venosa retiniana. Métodos: estudio prospectivo, intervencional, aleatorio y comparativo realizado en 34 pacientes. El grupo 1 (16 pacientes) con inyección intravítrea de acetato de triamcinolona y el grupo 2 (18 pacientes) con inyección de bevacizumab hasta completar 3 dosis en cada grupo, seguida la tercera dosis de grid macular. La dosis inicial fue a los 3 meses de la afección, y la evaluación final a los 12 meses. Se evaluó la agudeza visual mejor corregida (Snellen), grosor macular y complicaciones. Resultados: en el grupo 1 la mejor agudeza visual con corrección evolucionó de 0,29 (0,05-0,5) a 0,64 (0,05-1,0); en el grupo 2 de 0,24 (0,05-0,5) a 0,66 (0,11,0). El grosor macular en el grupo 1, de 551,3 (346-967) micras, mejoró a 204,06 (112-449) micras; en el grupo 2, de 546,2 (283-1020) micras, hasta un grosor retinal foveal de 181,05 (112-312) micras. Como complicaciones, en el grupo 1 hubo un incremento de la tensión ocular en el 25,0 por ciento de los pacientes y una progresión de catarata en el 12,5 por ciento. Conclusiones: el tratamiento de inyección intravítrea de bevacizumab en el edema macular secundario a oclusiones venosas de rama retiniana muestra mejor resultado que el de acetato de triamcinolona. También son menores las complicaciones asociadas al bevacizumab(AU)

Objective: to compare the results of the intravitreal treatment with bevacizumab and with triamcinolone acetonide in the macular edema secondary to branch retinal vein occlusion. Methods: a prospective, interventional, random and comparative study was carried out in 34 patients. The first group (16 patients) received intravitreal triamcinolone acetonide injection whereas the second group (18 patients) had bevacizumab injection up to completing three doses in each group, followed by a third dose of macular grid. The initial dose was applied three months after the occurrence of edema and the final evaluation was made 12 months afterwards. Best corrected visual acuity (Snellen's chart), the macular thickness and complications were assessed. Results: in the first group, the best corrected visual acuity increased from 0,29 (0,05-05) to 0,64 (0,05-1,0) whereas in the second group it went from 0,24 (0,05-05) to 0,66 (0,1-1,0).The macular thickness of 551,3 (346-967) microns of the first group improved when reaching 204,06 (112-449) microns and that of the second group went from 546,2 (283-1020) microns to 181,05 (112-312) microns. As to the complications, 25 percent of patients of the first group experienced eye hypertension, and 12,5 percent of patients in the same group had cataract progression. Conclusions: intravitreal bevacizumab injection treatment of the macular edema secondary to branch retinal vein occlusion was better than that based on triamcinolone acetonide injection. The complications associated to bevacizumab treatment were fewer(AU)

Effect of Primary Intravitreal Bevacizumab Injection on Stage 3 Retinopathy of Prematurity with Plus Signs

PURPOSE: To evaluate the efficacy and safety of primary intravitreal bevacizumab injection in stage 3 retinopathy of prematurity with plus signs. METHODS: We reviewed retrospectively the medical records of 30 eyes of 16 patients diagnosed with stage 3 retinopathy of prematurity with plus signs treated with primary intravitreal bevacizumab injection between March 1, 2011 and February 28, 2013 and followed up for at least 9 months. RESULTS: Mean gestational age was 26 + 4 weeks +/- 11 days and mean birth weight was 822 +/- 251.4 g. The locations of disease were zone II in 24 eyes and zone III in 6 eyes. Intravitreal bevacizumab injection was performed after the mean 1.3 +/- 1 day after plus signs were detected. Mean postconceptional age at treatment was 38 + 2 weeks +/- 16 days. Mean follow-up period was 16.6 +/- 6.9 months. Plus signs started to regress after the mean 4.6 +/- 2.3 days after injection and completely regressed after the mean 24.3 +/- 12.4 days. Cataract extraction was performed in 1 eye due to a cataract that appeared not associated with the injection procedure, but was regarded as a treatment failure. There were no local or systemic complications. CONCLUSIONS: Primary intravitreal bevacizumab injection in stage 3 retinopathy of prematurity with plus signs demonstrated excellent short-term efficacy and safety.

Intravítrea de bevacizumab en el edema macular secundario a oclusión venosa de rama retiniana / Intravitreal bevacizumab injection treatment for the macular edema secondary to the retinal vein branch occlusion

OBJECTIVE: to evaluate the results of the treatment of bevacizumab in the macular edema secondary to occlusion of a branch retinal vein. METHODS: prospective, interventional, not comparative study, in 18 patients with macular edema secondary to occlusion of branch retinal vein. The treatment was of intravitreal injection of Bevacizumab (up to 3 dose) followed by grid macular if was necessary. The initial evaluation went to the 3 months of the occlusion and they were followed the patients by 12 months. It was evaluated the corrected better visual acuity, macular thickness and the occurrence of complications. RESULTS: the patients were 7 men (38,89%) and 11 women (61,11 %) 63,1 (44-80) years of age average. Of the treatment, 7 required 1 dose (38,89 %), 6 with 2 dose (33,33 %) and 5 with 3 dose (27,77 %) more grid macular. To the beginning the average of the best visual acuity with correction was of 0,24 (0,05-0,5) and of the macular thickness of 546,2 (283-1 020) µ. To the 12 months the best visual acuity with correction average improved at 0,65 (0,1-1,0) and the macular thickness at 181,05 (112-312) µ. there were not complications associated with proceeding. CONCLUSION: the injection of bevacizumab constitutes an effective treatment in the edema secondary macular to occlusion of branch veined retiniana.

OBJETIVO: evaluar los resultados del tratamiento de intravítrea de bevacizumab en el edema macular secundario a oclusión de rama venosa retiniana. MÉTODOS: estudio prospectivo, intervencional, no comparativo, en 18 pacientes con edema macular secundario a oclusión de rama venosa retiniana. El tratamiento fue de inyección intravítrea de bevacizumab (hasta 3 dosis) seguido de grid macular si era necesario. La evaluación inicial fue a los 3 meses de la oclusión y se siguieron a los pacientes por 12 meses. Se evaluó la agudeza visual mejor corregida, el grosor macular y la ocurrencia de complicaciones. RESULTADOS: los pacientes fueron 7 hombres (38,89 %) y 11 mujeres (61,11 %). El promedio de edad fue de 63,1 (44-80). Durante el tratamiento, hubo 7 pacientes con 1 dosis (38,89 %), 6 con 2 dosis (33,33 %) y 5 con 3 dosis (27,77 %) más grid macular. Al inicio, el promedio de la mejor agudeza visual con corrección fue de 0,24 (0,05-0,5) y del grosor macular de 546,2 (283-1 020) µ. A los 12 meses la mejor agudeza visual con corrección promedio mejoró a 0,65 (0,1-1,0) y el grosor macular a 181,05 (112-312) µ. No hubo complicaciones asociadas con el proceder. CONCLUSIÓN: la inyección intravítrea de bevacizumab constituye un tratamiento eficaz en el edema macular secundario a oclusión de rama venosa retiniana.

Morphological changes in spectral domain optical coherence tomography guided bevacizumab injections in wet age-related macular degeneration, 12-months results.

Purpose: To describe retinal changes during Spectral Domain Optical Coherence Tomography (SD-OCT) guided bevacizumab treatment for neovascular age- related macular degeneration (AMD). Se􀄴 ings and Design: Single center observational study. Materials and Methods: We confi rmed wet AMD in 47 eyes of 45 patients by fl uorescein angiography and SD-OCT. After bevacizumab injection, we examined the patients at 4-week intervals. During each follow-up control, we performed SD-OCT and a complete ophthalmic examination. Criteria for reinjection were visual acuity loss of more than fi ve ETDRS le􀄴 ers, and/or increase of central retinal thickness, sub-retinal fl uid, intra-retinal fl uid, pigment epithelium detachment. If reinjection criteria were not met, we advised the patient to return in 4 weeks’ time for the next scheduled follow-up. We used 3-dimensional SD-OCT to measure photoreceptor defects and sub-retinal fi brosis. The main effi cacy endpoints were the SD-OCT measurements of the size of photoreceptor defects, the size of external membrane defects and the central retinal thickness. Results: Over the 12 months study period, the percentage of scans in 3-D imaging mode showing visible defects of the junction between inner and outer segments of photoreceptors increased from 38.96 to 53.8%. The percentage of scans in 3-D imaging mode with visible sub-retinal fi brosis increased from 33 to 52% and mean central retinal thickness decreased from 333 μm (96-900 μm) to 272 μm (P = 0.011). Conclusion: In long-term anti- Vascular endothelial growth factor (VEGF) treatment for neovascular AMD, photoreceptor defects and fi brosis progress despite a decrease in central retinal thickness and improvements in visual acuity. We would encourage further discussion as to whether this is the natural course of the disease or a result of the treatment.

Comparison of endostatin (endostar) and avastin's inhibition effect on mice choroidal neovascularization / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the inhibition effect of endostatin ( endostar ) on mice choroidal neovascularization model ( CNV) and compare with the Avastin. METHODS: Using 532nm laser photocoagulation to establish a mouse model of CNV. We observed the formation of CNV by histopathological examination after 2wk later. Forty successful models of mice were randomly divided into control group (group 1, 10 rats), normal saline group ( group 2, 10 rats ), endostatin group (group 3, 10 rats) and avastin group (group 4, 10 rats) . The drugs were injected into the mice' vitreous after photocoagulation 2wk later. Then 1wk later, we took the mice eyeballs to perform the HE and immunohistochemical staining to observe. The statistical analysis of ANOVA was done by SPSS 16. 0 and the LSD-t test was used for multiple samples, taking PRESULTS: Two weeks later, HE histopathological examination was done , light microscope showed large amount of new vessels' formation, the positive rate for CNV was 72. 8%. The blank control group compared with the normal saline group P>0. 05, had no inhibitory effect on CNV;endostatin treated group compared with control group, P CONCLUSION: Laser-induced CNV animal models of colored mice C57BL/6J is of short time and high rate establishment and it is an ideal model for CNV study. Endostar has certain inhibitory effect on CNV, and it is likely to become one of the important drugs for CNV-related diseases in the future.

Clinical observation of bevacizumab (avastin) for treating age - related macular degeneration / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To evaluate the safety and efficacy of intravitreal bevacizumab ( avastin ) injection in patients with exudative age related macular degeneration ( AMD) . METHODS: The records of patients treated with intravitreal injection of 1. 75mg bevacizumab for AMD were retrospectively reviewed. All patients were evaluated by complete ophthalmic examination, optical coherence tomography and fundus fluorescein and/or indocyanine green angiography. Observation was made on the best corrected visual acuity ( BCVA) , intraocular pressure, and the changes of lens, vitreous, central retinal thickness (CFT) and total macular volume (TMV), at 1d, 3d, 7d, 1mo and 6mo after the treatment and then compared with those of pre - operation. Repeated treatment with intravitreous bevacizumab occurred if there were signs of persistent or recurrent exudation. And all cases were followed up at least 6mo. An intravitreal injection of bevacizumab (1. 75mg) was given once every 6wk. RESULTS:All 50 eyes of 48 patients with the average of 58±20. 46 years old were included. The mean baseline of BCVA and CFT were 0. 82±0. 53, and 364. 97±151. 83μm respectively. Although there was no significant decrease in mean CFT and TMV one week after the injection, the mean BCVA had significant improvement. At the last visit of 9. 7mo follow - up, BCVA, CRT and TMV showed significant improvements over baseline values. BCVA was improved by at least two lines in 32 eyes (64%),remained stabilization in 18 eyes (36%) at the last visit. A total of 98 injections were performed and the average number of injections was 1. 98 for each eye in the group. About 50%of re - injections gained at least two lines of vision improvement one week postoperatively. There were no serious adverse events during the treatment. CONCLUSION: Intravitreal bevacizumab ( avastin ) injection for managing CNV due to age-related macular degeneration is safe and few side effects. Intravitreal avastin associated with improvement in visual acuity ( VA ) , which can reduce macular edema and choroidal neovascularization leakage. But a prolonged treatment effect needs further observation.

The Change of Microaneurysm in Diabetic Retinopathy Patients Who Undergo Intravitreal Avastin (Bevacizumab) Injection

PURPOSE: To evaluate microvascular change (microaneurysm) in diabetic retinopathy patients who undergo intravitreal bevacizumab injection using fluorescein angiography (FAG). METHODS: Thirty one eyes of 31 diabetic retinopathy patients undergoing intravitreal bevacizumab injection (1.25 mg/0.05 mL) in only 1 eye were included in this study. The control group (31 eyes) consisted of the fellow eyes. We excluded cased with intravitreal bevacizumab injection in both eyes and medial opacity obscuring three fundus image due to vitreous hemorrhage. The microaneurysmal change was analyzed at the same site the circle with optic disc radius and macula using FAG 2 to 4 months after injection. RESULTS: The average number of microaneurysms was 42.58 +/- 33.93 and significantly decreased to 28.74 +/- 28.06 after intravitreal bevacizumab injection (p < 0.05). The decrease of 35.70 +/- 24.79% in the treatment group was statistically higher than 13.95 +/- 38.21% in the control group with the fellow eyes (p < 0.05). CONCLUSIONS: In the present study, intravitreal bevacizumab injection reduced neovascularization, cystoid macular edema. Therefore this data can be used for future research on microvascular changes in the retina.

Stability and Sterility of Bevacizumab after Withdrawal into a Syringe and Refrigeration or Freezing

PURPOSE: The aim of this study was to evaluate the stability and sterility of bevacizumab (Avastin, Genentech, Inc., San Francisco, CA, USA) after withdrawal into multiple doses from single-use vials. METHODS: Bevacizumab was repeatedly and aseptically drawn from new vials into 1 cc plastic syringes and refrigerated in the dark at 4degrees C for 0, 3, 6, 12, 28, 38, 46, 52, or 63 weeks or at -10degrees C for 0, 3, 6, 12, 38, 46, or 52 weeks. The stability of bevacizumab was assessed by enzyme-linked immunosorbent assay (ELISA) and compared with that of controls (0 weeks). The contents of the fractionated bevacizumab syringes were analyzed for microbial growth. RESULTS: When we assessed the relative stability of the bevacizumab stored at 4degrees C, there was no concentration change for up to 12 weeks. However, concentration decreased by less than 2% between 28 weeks and 46 weeks. Samples stored at -10degrees C were stable up to 52 weeks. All of the fractionated syringes maintained >90% stability compared with controls for up to one year in both the refrigerated group and the frozen group. The microbial study showed no significant positive results for up to 12 weeks. After intravitreal bevacizumab injection, the statuses of all patients improved, with no signs of intraocular infection. We observed no cases of intraocular infection or complications among the patients. CONCLUSIONS: Fractionating and storing smaller amounts from single-use vials is a safe method for intravitreal bevacizumab injection.

Laboratory research advancement in bevacizumab / 中华实验眼科杂志

Vascular endothelial growth factor (VEGF) is a key factor for neovascular diseases of ophthalmology.Bevacizumab is a full-length,humanized monoclonal IgG antibody,which prevents VEGF-A to combine with its receptors on the endothelial surface,and inhibits the endothelial cell proliferation and new blood vessel formation.Nowadays,anti-VEGF drugs are widely used to treat neovascularization diseases in ophthalmology.Bevacizumab has been more extensively applied because of its high security and low cost.The article reviewed the advancement of laboratory researches on the permeability,safety,pharmacokinetics of bevacizumab and research in vitro.

Influence of intravitreal avastin on the expression of cell factors in retinal proliferative membrane in proliferative diabetic retinopathy eye / 中华实验眼科杂志

Background A main cause of visual impairment in proliferative diabetic retinopathy (PDR) is vitreous hemorrhage and retinal detachment due to contraction of fibrovascular membrane.To explore the pathogenic mechanism of fibrovascular membrane is a new target for the prevention and management of PDR.Objective This study was to determine the change in expression of vascular endothelial growth factor (VEGF),connective tissue growth factor(CTGF) and pigment epithelium derived factor(PEDF) in the proliferative membranes of patients with PDR after intravitreal injection of avastin,an anti-VEGF agent.Methods This study was approved by the Medical Ethic Committee of Tianjin Medical College,and written informed consent was obtained from each patient before enrollment.A prospective randomized-controlled study was designed.Twenty-six eyes of 24 patients with PDR scheduled for surgery were enrolled from January to June,2008 in Tianjin Medical College Eye Hospital.The patients were randomized into the simple vitrectomy group and avastin injection combined with vitrectomy group,with matched gender,age and disease duration.1.25 mg (0.05 ml) of avastin was intravitreally injected prior to surgery,and vitrectomy was performed 10 days after injection in the avastin injection combined with vitrectomy group,and only vitrectomy was given in the simple vitrectomy group.Preretinal membrane was collected during the surgery.Expression of VEGF,CTGF and PEDF in the preretinal membranes was assayed by immunochemistry.Results VEGF,CTGF and PEDF were expressed in the cytoplasm.The rate of VEGF expression in the preretinal membranes was 30.77％ in the avastin injection combined with vitrectomy group,showing a significant reduction in comparison with the simple vitrectomy group(100.00％)(U =4.000,P＜0.01).The rate of expression CTGF was remarkable elevated in the avastin injection combined with vitrectomy group compared with the simple vitrectomy group (92.31％ vs.62.54％)(U=7.500,P=0.048).However,no significant difference was found in the expression rate of PEDF between the two groups(100.00％ vs.92.31％) (U =65.500,P =0.299).Conclusions The results suggest that intravitreal injection of anti-VEGF drugs resulted in the decrease of VEGF expression and increased CTGF expression in proliferative membranes from patients with PDR.

Utilización del bevacizumab en la neovascularización corneal / Use of Bevacizumab in corneal neovascularization

La neovascularización corneal es causa de pérdida de su transparencia y también es un factor de riesgo para el rechazo secundario de trasplantes en esa estructura. El bevacizumab es un anticuerpo monoclonal humanizado que bloquea selectivamente la cascada de formación del VEGF y con esto disminuye la formación de vasos sanguíneos...

Neovascularization of the cornea is a cause of loss of transparency of the same and is also a risk factor for secondary rejection corneal transplants. Bevacizumab is a humanized monoclonal antibody that selectively blocks the formation of the VEGF cascade and, with this, decreases the formation of blood vessels...

Observation and nursing of intravitreous injection of Avastin combined with laser photocoagulation for macular edema induced by vein occlusion / 中国实用护理杂志

Objective To investigate the treatment effect and nursing of intravitreous injection of Avastin combined with laser photocoagulation in macular edema caused by vein occlusion.Methods 38 patients(38 macular edema eyes)who had macular edema caused by retinal vein occlusion and accepted intravitreous injection of Avastin combined with laser photocoagulation were selected.Relevant nursing was given before and after the clinical treatment.The visual acuity and retinal thickness were observed and recorded.Results Visual acuity was improved in 36 eyes(94.7％),no change occurred in 2 eyes(5.3％).The thickness of macular was statistically significant compared with before treatment and 2,4,6 weeks after treatment.Conclusions Intravitreous injection of avastin combined with laser photocoagulation is effective on macular edema caused by vein occlusion.Successful treatment is guaranteed by psychological nursing,treatment guidance and health guidance.