Effects of bevacizumab on retinal function in isolated vertebrate retina.

BACKGROUND: Bevacizumab (Avastin) is a recombinant protein that targets vascular endothelial growth factor (VEGF). In vitro, bevacizumab inhibits VEGF induced cell proliferation and tissue factor production. Abnormal angiogenesis involving VEGF is a central event during the development of choroidal neovascularisation (CNV). The present study was designed to evaluate the short term toxic effects of bevacizumab on retinal function for a therapeutic intraocular application. METHODS: Isolated bovine retinas were perfused with an oxygen pre-incubated nutrient solution. The electroretinogram (ERG) was recorded as a transretinal potential using silver/silver chloride electrodes. Bevacizumab was added in different concentrations to the nutrient solution for 45 minutes. Thereafter the retina was reperfused for 60 minutes with normal nutrient solution. The percentage of a-wave and b-wave reduction during the application of bevacizumab was calculated and compared to control recordings. RESULTS: During the application of three different concentrations of bevacizumab (0.08 mg/ml, 0.25 mg/ml, 0.8 mg/ml) no significant reduction of the a-wave and b-wave amplitude was observed. During the washout, the ERG amplitudes were unchanged. CONCLUSION: The present study suggests that an intraocular application of 0.25 mg/ml bevacizumab for the treatment of CNV is reasonable. No significant short term effects of bevacizumab on retinal function were detected, but long term effects cannot be excluded.

[Tumor of the caruncle of uncertain malignancy]. / Karunkeltumor unklarer Dignität.

CASE REPORT: A sixty year old woman presented with a tumor of the caruncle that had persisted for one year. Ophthalmologic history was unremarkable. Physical examination disclosed an indolent, tight elastic, highly vascularizated tumor. The lesion measured five millimeter in diameter. Histopathology revealed tall columnar cells with small round nuclei. The cytoplasm stained positive with hematoxylin and eosin. The typical histopathologic features were consistent with an oncocytoma. CONCLUSION: Tumors of the caruncle are very heterogenous because the caruncle contains tissues of the conjunctiva and the epidermis. Therefore to exclude a malignant process an excisional biopsy should always be performed even so in general tumors of the caruncle are benign. The most frequent tumors of the caruncle are papilloma, nevi, pyogenic granuloma, epithelial inclusion cyst and chronic inflammation. In only 4 % of the cases oncocytomas are found even the oncocytoma is considered to be a typical tumor of the caruncle.

["Do you have a remedy for macular degeneration?" A field study about the advice given on dietary supplementation in 60 German pharmacies]. / "Haben Sie ein Mittel gegen Makuladegeneration?" Eine Feldstudie in 60 deutschen Apotheken über die Beratung zu Nahrungsergänzungsmitteln.

PURPOSE: Since completion of the AREDS study, evidence has accumulated to suggest that some form of dietary supplementation may be of value in special individuals who are at risk of progressive age-related macular degeneration (ARMD). We wanted to find out which of the many supplements available are recommended in practice and which instructions, promises, and purchasing arguments are used by German pharmacies. METHODS: A blinded consultation following a standardized protocol was carried out in 60 pharmacies. RESULTS: In 36 pharmacies specific products for dietary supplementation were recommended, but the dosage never complied with the AREDS study, and in 24 pharmacies, the necessity for a medical examination or consultation with an ophthalmologist was not mentioned. Possible interactions with other drugs or side effects were generally excluded. CONCLUSIONS: Potential risks of supplement intake were underestimated. Medical knowledge of the most frequent cause of blindness in the Western world was insufficient. A clear policy of recommendations according to evidence-based criteria is needed.