Comparison of two doses of primary intravitreal bevacizumab (Avastin) for diffuse diabetic macular edema: results from the Pan-American Collaborative Retina Study Group (PACORES) at 12-month follow-up

Arévalo, J. Fernando; Sánchez, J. García; Fromow-Guerra, Jans; Wu, Lihteh; Berrocal, María H.; Farah, Michel Eid; Cardillo, J.A.; Rodriguez, Francisco J.

doi:10.1007/s00417-008-1034-x

Cited by 99 publications

(61 citation statements)

References 46 publications

(51 reference statements)

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“…The application of VEGF inhibitors is a relatively new therapy with proven effect which is widely used because it is tolerated well and because of its low risk of systemic and eye complications [11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Optical Coherence Tomography Patterns in Diabetic Macular Edema can Predict the Effectiveness of Intravitreal Bevacizumab Combined with Macular Photocoagulation

Radovanova¹

2014

J Clin Exp Ophthalmol

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Purpose: To compare the effectiveness of intravitreal bevacizumab (IVB) combined with macular photocoagulation (MPC) for the treatment of patients with different optical coherence tomography (OCT) patterns of diabetic macular edema. Methods:In this prospective study were included 72 eyes of 58 patients with nonproliferative diabetic retinopathy (NPDR) and nontractional DME with central macular thickness (CMT) over 300 μm. The eyes were categorized into three groups according to OCT features: 22 eyes with diffuse retinal thickening (DRT), 30 eyes with cystoid macular edema (CME), 20 eyes with serous retinal detachment (SRD). All patients received a single dose (1.25mg/0.05ml) of IVB. MPC was applied one month later (25-30 days). Early Treatment Diabetic Retinopahty Study ( ETDRS) best corrected visual acuity (BCVA) and СМТ were assessed before and after the treatment (in the 1st, 3rd and 6th month).Results: At month 6, mean BCVA changed with +8.27 ± 10.7 ETDRS letters (P=0.074), -0.97 ± 8.2 ETDRS letters (P=0.351) and +1.8 ± 10.1 ETDRS letters (P=0.925), respectively, for DRT, CME and SRD groups. Mean CMT decreased by 80.7 ± 65.7 μm (P=0.003) in DRT group, by 24.5 ± 104.6 μm (P=0.909) in CME group and by 51.7 ± 124.3 μm (P=0.580) in SRD group. The DRT group was associated with superior BCVA improvement and greater reduction in CMT as compared with the CME and SRD groups. Conclusions:Intravitreal injection of bevacizumab combined with MPC is more effective in the DRT pattern than in the CME or SRD patterns of DME. The pattern of DME shown by OCT may predict the effectiveness of combination treatment.

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Section: Introductionmentioning

confidence: 99%

“…Combining these, i.e. the application of MPC in the 4th week after the intravitreal anti-VEGF, when the edema has been reduced to a maximum [14,17], should extend the effect of the treatment and prevent subsequent intravitreal injections.…”

Section: Introductionmentioning

confidence: 99%

Optical Coherence Tomography Patterns in Diabetic Macular Edema can Predict the Effectiveness of Intravitreal Bevacizumab Combined with Macular Photocoagulation

Radovanova¹

2014

J Clin Exp Ophthalmol

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“…Bevacizumab is a full-length, recombinant humanized monoclonal immunoglobulin G1 (IgG1) that binds to and inhibits the activity of VEGF-A, thereby inhibiting angiogenesis 8 . A related compound, Ranibizumab (Lucentis), is a high affinity recombinant monoclonal antibody derived from the same parent murine antibody as bevacizumab and also neutralizes all isoforms of VEGF-A 6 .…”

Section: Discussionmentioning

confidence: 99%

“…VEGF antagonists disrupt these pathways, thus preventing and regressing corneal neovascularization. Blockage of VEGF with bevacizumab and ranibizumab has been a successful treatment in decreasing visual morbidity associated with abnormal vascular conditions of the choroid and retina 8 .…”

mentioning

confidence: 99%

Inhibition of Corneal Neovascularization by Subconjunctival Injection of Ranibizumab and Bevacizumab in Rabbit Cornea

Ekinci¹,

Çağatay²,

Yazar³

et al. 2013

Kafkas Univ Vet Fak Derg

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The aim of this study was to evaluate the effects of subconjunctival ranibizumab and bevacizumab injection on angiogenesis in the rabbit cornea. The corneas of 24 New Zealand rabbits were cauterized with silver nitrate to induce neovascularization. The eyes were irrigated with 10 ml of 0.9% saline solution. The alkaline burns were similar in all the rabbits. At the 24 h after cauterization, the rabbits were divided into three groups of eight animals each: The first group (GC) received 0.02 ml 0.9% saline solution as a control group whereas second (GR) and third (GB) groups received 0.5 mg ranibizumab and 1.25 mg bevacizumab by subconjunctival injection, respectively, on days first and 7 after lesion. The rabbits' corneas were extracted on the 14th day. Digital photographs of the corneas were obtained and the newly formed vessels were analyzed in a computerized system (google sketch-up program). The rates of these vessels were compared between the groups. Ranibizumab and bevacizumab were both effective on inhibition of angiogenesis, in comparison to 0.9% saline solution (P<0.05). Ranibizumab was found to be statistically more effective to reduce corneal neovascularization than bevacizumab (P<0.05). Bevacizumab and ranibizumab were found to be effective in inhibiting the corneal neovascularization in the rabbit cornea. Ranibizumab seemed more effective than bevacizumab on inhibiting corneal neovascularization in the rabbit cornea. Keywords: Ranibizumab, Bevacizumab, Rabbit cornea, Corneal neovascularization, Angiogenesis Korneal Neovaskularizasyonun Subkonjonktival Ranibizumab ve Bevacizumab Enjeksiyonu ile Tavşan Korneasında İnhibisyonu ÖzetBu çalışmanın amacı; subkonjunktival olarak uygulanan ranibizumab and bevacizumab'ın tavşan korneasında anjiyogenezis üzerine etkilerini değerlendirmekti. Yirmi dört adet Yeni Zelanda tavşanının korneaları neovaskülarizasyon oluşturmak için gümüş nitrat ile koterize edildi. Gözler 10 ml %0.9 salin solusyonu ile yıkandı. Tüm gözlerde eşit miktarda kimyasal yanık oluşturulmasına dikkat edildi. Koterizasyon sonrası 24. saatte tavşanlar üç gruba ayrıldı: Kontrol grubuna (GC) (n=8) subkonjunktival 0.02 ml %0.9'luk salin solüsyonu; Grub Ranibizumab'a (GR) (n=8) subkonjunktival olarak 0.5 mg ranibizumab ve Grup Bevasizumab'a (GB) (n=8) ise subkonjunktival olarak 1.25 mg bevacizumab 1. ve 7. günlerde uygulandı Topical antibiotik tedavisi sonrası, tavşan korneaları 14. günde çıkarıldı. Korneaların digital fotoğrafları alınarak yeni oluşmuş damarlar bilgisayar programı (google sketch-up programı) yardımıyla analiz edildi. Yeni oluşan damar yapılarının alanının kornea alanına oranları gruplar arasında değerlendirildi. Ranibizumab ve Bevasizumab'ın her ikisi de anjiyogenez inhibisyonunda %0.9 salin solüsyonuna kıyasla (P<0.05) daha etkili olduğu saptandı.Ranibizumab'ın korneal neovaskülarizasyon azaltıcı etkisi Bevasizumab'tan istatistiksel olarak anlamlı (P<0.05) derecede fazla bulundu. Bevasizumab ve Ranibizumab'ın tavşan korneasında neovaskularizasyonu inhibe etmekte etkili olduğu tesp...

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“…Some studies suggested use of higher dosage of iVB to achieve a better visual and anatomical outcomes but studies that compared the efficacy of 1.25 mg with 2.5 mg iVB for DMO have shown that no significant difference in terms of BcVa and Oct was observed between iVB at doses of 1.25 mg or 2.5 mg. 71,72 the frequency of iVB injections for DMO is another controversial subject. the effectiveness of intravitreal bevacizumab injection has been reported to last 6, 8 and 12 weeks.…”

Section: Bevacizumab Dosage and Frequency Of Injections For Diabetic mentioning

confidence: 99%

Intravitreal Bevacizumab for Treatment of Diabetic Macular Oedema

Ramin¹,

Azarmina²,

Soheilian³

2013

European Ophthalmic Review

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Abstractdiabetic macular oedema (dMo) is a leading cause of vision loss in the working-age population worldwide. Numerous early studies suggest an important role for intravitreal anti-VEGF agents such as bevacizumab in the management of dMo. We reviewed manuscripts that had investigated pharmacokinetic, efficacy, safety, dose and frequency of intravitreal bevacizumab (iVB) injections as well as effect of macular ischaemia, initial macular thickness and optical coherence tomography (ocT) patterns of dMo on the final results of treatment with iVB. in summery literature searches disclosed that almost all studies published up to now provided evidence supporting use of iVB for treatment of either naïve or persistent dMo in short and long term up to 2 years. KeywordsBevacizumab, clinically significant diabetic macular oedema, diabetic retinopathy, macular laser photocoagulation, triamcinolone acetonide Pathophysiology of Diabetic Macular OedemaSeveral physiological mechanisms have been proposed to contribute to the pathogenesis of dMo. The exact mechanisms by which elevated glucose initiates the vascular disruption and results in the ultimate blood retinal barrier (BRB) breakdown in diabetic retinopathy remain poorly defined. There are several hypotheses that contribute to dMo formation including:1. increase in hydrostatic pressure that was described by Starling.Similar to congestive heart failure, dMo can be considered as a congestive macular oedema. Based on Starling law hydrostatic and oncotic pressure counteract each other; pressure differences are responsible for the movement of fluid between tissue beds and intravascular spaces. changes in vessel diameter together with increased hydrostatic pressure can contribute to oedema formation. Furthermore the above mentioned mechanism can increase in shear stress which may cause damage to endothelial cells and cause endothelial decoupling over time. [9][10][11] 2. ischaemia secondary to hypoxia can lead to decrease in oxygen tension in retina which results in vasodilation of the retinal vessels that can increase macular oedema by increasing hydrostatic pressure. increased in oxygen tension may decrease macular oedema by reversing the earlier described mechanism.3. hyperglycaemia per se or together with other mechanisms may induce endothelial dysfunction and cause more vascular damage. [12][13][14] 4. increased VEGF production: VEGF mediates angiogenesis by promoting endothelial cell migration, proliferation and survival.amongst the various VEGF family members, VEGF-a, is a critical regulator of ocular angiogenesis and vascular permeability. 15VEGF can cause rapid post-translational modifications to tight junctions by stimulating occluding phosphorylation and inducing tyrosine phosphorylation of zonula occludence that result in

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Comparison of two doses of primary intravitreal bevacizumab (Avastin) for diffuse diabetic macular edema: results from the Pan-American Collaborative Retina Study Group (PACORES) at 12-month follow-up

Cited by 99 publications

References 46 publications

Optical Coherence Tomography Patterns in Diabetic Macular Edema can Predict the Effectiveness of Intravitreal Bevacizumab Combined with Macular Photocoagulation

Optical Coherence Tomography Patterns in Diabetic Macular Edema can Predict the Effectiveness of Intravitreal Bevacizumab Combined with Macular Photocoagulation

Inhibition of Corneal Neovascularization by Subconjunctival Injection of Ranibizumab and Bevacizumab in Rabbit Cornea

Intravitreal Bevacizumab for Treatment of Diabetic Macular Oedema

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