Effects of intravitreally injected bevacizumab on vascular endothelial growth factor in fellow eyes

Abstract

Purpose To determine the level of vascular endothelial growth factor (VEGF) in the fellow eyes after an intravitreal injection of bevacizumab in one eye. Methods Eight patients who had similar findings of with proliferative diabetic retinopathy (PDR) in both eyes were studied (four patients had rubeosis, and four patients did not have rubeosis in the anterior chamber). All patients received an intravitreal injection of bevacizumab(1.25 mg) in one eye. Samples of aqueous humor were collected from the injected eyes just before and one day after the injection, and after 7 days from untreated fellow eyes. The concentration of VEGF was measured by ELISA. Results After one day, the VEGF level in injected eyes was significantly reduced from 3230.3±2136.8 pg/ml to 3.1±3.6 pg /ml (P<0.05) in eyes with rubeosis and 465.0±78.8 pg/ml to 0 pg/ml (P<0.05) in those without rubeosis. After seven days, the VEGF levels of the fellow eyes were still significantly lower than that in the injected eyes before the injection (688.5±443.1 pg/ml in the rubeosis group, and 7.8±13.2 pg/ml in the no rubeosis group, P<0.05, P<0.05). Conclusion A single intravitreal injection of bevacizumab significantly reduced the VEGF concentrations in the aqueous humor of the fellow untreated eye.

Plasma levels of vascular endothelial growth factor before and after intravitreal injection of bevacizumab, ranibizumab and pegaptanib in patients with age-related macular degeneration, and in patients with diabetic macular oedema

“…The paper ‘Effects of intravitreally injected bevacizumab on VEGF in fellow eyes’ by Matsuyama, and the follow-up paper about VEGF plasma levels in diabetic patients after a single injection of bevacizumab was not really appealing 7 8. In these studies, a significant decrease of plasma VEGF after the intravitreal injection of bevacizumab at 1 day, 7 days and even at 1 month in patients with diabetic retinopathy was observed.…”

Reduction of Diabetic Macular Edema in the Untreated Fellow Eye Following Intravitreal Injection of Aflibercept

“…There are multiple reports of treatment effect, measured by reduction of central foveal thickness (CFT) and improvement in visual acuity, in the untreated fellow eye with intravitreal injection of other anti-VEGF agents, including bevacizumab (Avastin; Genentech, South San Francisco, CA) and ranibizumab (Lucentis; Genentech, South San Francisco, CA). [1][2][3] Here we present the first reported case, to our knowledge, of improvement of DME in the untreated fellow eye with injection of intravitreal aflibercept.…”

“…Reduction of DME in the fellow, untreated eye after intravitreal injection of an anti-VEGF agent has been reported with bevacizumab and ranibizumab. [1][2][3] This effect may be more common with bevacizumab; in a series of 35 patients treated in one eye with ranibizumab, no statistically significant reduction in CFT was found in the fellow eye, whereas in contrast, a significant reduction in CFT was found with bevacizumab in the untreated eye of 55 patients. 6 There are reasonable clinical and pharmacokinetic data to support the reduction of DME with bevacizumab in the fellow, untreated eye.…”

Ocular Pharmacokinetics of Bevacizumab in Vitrectomized Eyes with Silicone Oil Tamponade

“…Indeed, it has been reported that regression of rubeosis or reduced VEGF levels in the contralateral eye was observed when bevacizumab was injected intravitreally. 20,21 In our study, the retina in the right eye was divided into upper and lower portions from the medullary ray, and sampled separately. We hypothesized that after the bevacizumab enters the limited vitreous fluid between the oil and retina, the gravity could lead to a higher drug concentration in the inferior fluid body and inferior retina.…”