Intracameral bevacizumab as an adjunct to trabeculectomy: a 1-year prospective, randomised study

Vandewalle, Evelien; Pinto, Luís Abegão; Bergen, Tine Van; Spielberg, Leigh; Fieuws, Steffen; Moons, Lieve; Spileers, Werner; Zeyen, Thierry; Stalmans, Ingeborg

doi:10.1136/bjophthalmol-2013-303966

Cited by 62 publications

(64 citation statements)

References 22 publications

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“…IC injections allow a diffuse distribution of the antibody in the anterior chamber and throughout the outflow route into the filtration bleb without disturbing conjunctival integrity. 7 Moreover, via this route of administration, the PlGF inhibitor may block the elevated aqueous PlGF concentrations described in glaucoma patients. 10 To broaden the therapeutic approach, different combination therapies with the PlGF antibody were tested.…”

Section: Discussionmentioning

confidence: 99%

“…5,15 Surgery was performed on both eyes, using a technique similar to trabeculectomy in humans. 7 During surgery, one eye was treated with MMC, whereas the other eye served as a control and was treated with NaCl. A surgical sponge soaked with either MMC 0.02% or NaCl 0.9% was placed on the exposed sclera for 2 minutes, and after removing the sponge, the ocular tissue was washed abundantly with NaCl.…”

Section: Determination Of Plgf Levels After MMC Administration In Rabmentioning

confidence: 99%

“…[3][4][5] It is known that inhibition of VEGF by bevacizumab can improve the surgical outcome in a rabbit model of glaucoma surgery 5,6 and in prospective randomized clinical trials. 7,8 Moreover, bevacizumab in combination with mitomycin-C (MMC) showed complementary effects in the improvement of surgical outcome in a mouse model of GFS. 9 Although bevacizumab, with or without MMC, can improve surgical outcome by inhibiting angiogenesis and deposition of collagen, it is not able to reduce inflammation, another important process in postoperative healing.…”

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confidence: 99%

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The Combination of PlGF Inhibition and MMC as a Novel Anti-Scarring Strategy for Glaucoma Filtration Surgery

Bergen

Jonckx²,

Moons

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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Section: Discussionmentioning

confidence: 99%

Section: Determination Of Plgf Levels After MMC Administration In Rabmentioning

confidence: 99%

mentioning

confidence: 99%

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The Combination of PlGF Inhibition and MMC as a Novel Anti-Scarring Strategy for Glaucoma Filtration Surgery

Bergen

Jonckx²,

Moons

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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“…A total of 226 patients were enrolled in these 3 trials. In Vandewalle et al [15], patients were randomized to the bevacizumab group (experimental group) and placebo group (control group; 72 patients per group). MMC was used in both groups when the target pressure was measured as < 14 mm Hg.…”

Section: Literature Searchmentioning

confidence: 99%

Efficacy and Safety of Bevacizumab Combined with Mitomycin C or 5-Fluorouracil in Primary Trabeculectomy: A Meta-Analysis of Randomized Clinical Trials

et al. 2018

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Aim: The objective of this study was to evaluate the efficacy and safety of bevacizumab combined with antimetabolite as an adjunctive therapy in primary trabeculectomy for glaucoma. Materials and Methods: PubMed, Cochrane Library, and EMBASE were searched for relevant randomized controlled trials. Efficacy was evaluated by the postoperative mean intraocular pressure (IOP), complete success, and qualified success rates. Safety was evaluated by postoperative complications and surgical interventions. Results: A total of 3 randomized controlled trials were included in the meta-analysis. The primary outcome was postoperative mean IOP at the 12-month follow-up. No significant difference in IOP was found between the bevacizumab + antimetabolite (mitomycin c or 5-fluorouracil) group and the antimetabolite alone group (weighted mean difference –0.27; 95% CI –1.38 to 0.83). There were no significant differences in complete success rates, qualified success rates, postoperative complications, and surgical interventions between the experimental treatment group and the conventional treatment group. Conclusions: Results of the meta-analysis demonstrated that the combination of bevacizumab (1.25 mg/mL) with a regular concentration of antimetabolite did not show more benefit or harm compared with using antimetabolite alone. Further randomized controlled trials are needed to evaluate the efficacy and safety of bevacizumab combined with lower concentrations and a shorter application time of antimetabolite.

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“…Также, согласно исследованию E. Vanderwalle, введение 0,05 мл (1,25 мг) бевацизумаба в пе-реднюю камеру интраоперационно существенно повышает уровень успеха СТЭ и снижает необ-ходимость проведения послеоперационного нид-линга [71].…”

Section: применение ингибиторов Vegf после фистулизирующих антиглаукоunclassified

VEGF inhibitors in glaucoma surgery

Mamikonyan¹,

Petrov²,

Сафонова³

2016

Ophthalmology Reports

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Vascular endothelial growth factor (VEGF) is a signaling protein, that controls vasculogenesis, angiogenesis, vascular support and stimulates permeability of small blood vessels. The following isoforms are presently known: VEGF-A, VEGF-B, VEGF-C, VEGF-В and PGF. VEGF-A, that regulates neoangiogenesis and fibroblast formation, is thought to play the most important role in human organism. Increased expression of VEGF may lead to development and aggravation of pathological conditions including oncology. The article presents a review of preclinical and clinical studies of the main VEGF-inhibitors - bevacizumab and ranibizumab, as well as a brief account on other existing medications of this group. It describes ophthalmological indications for the use of antiangiogenetic agents, as well as the ways of their possible off-label use. The review presents investigations of intravitreal and intracameral injections of VEGF-inhibitors in patients with retinal, chorioidal, iris, and anterior chamber angle neovascularization. It gives examples of successful anti-VEGF use before Ahmed glaucoma valve drainage device implantation and in cases of neovascular glaucoma, induced by radiation therapy for intraocular tumors. Tenon’s capsule’s fibroblasts take part in the process of postoperative wound healing and scarring. According to the latest research, this process could be modulated by angiogenesis inhibitors. This review also recounts the use of anti-angiogenic agents to inhibit postoperative fibroblast proliferation, when used as monotherapy, or as an adjuvant to mitomycin С or 5-fluorouracil. It reviews the research on VEGF-inibitors use in combination with postoperative needling.

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Intracameral bevacizumab as an adjunct to trabeculectomy: a 1-year prospective, randomised study

Abstract: Peroperative administration of intracameral bevacizumab significantly reduces the need for additional interventions during the follow-up of patients undergoing trabeculectomy.

Cited by 62 publications

References 22 publications

The Combination of PlGF Inhibition and MMC as a Novel Anti-Scarring Strategy for Glaucoma Filtration Surgery

The Combination of PlGF Inhibition and MMC as a Novel Anti-Scarring Strategy for Glaucoma Filtration Surgery

Efficacy and Safety of Bevacizumab Combined with Mitomycin C or 5-Fluorouracil in Primary Trabeculectomy: A Meta-Analysis of Randomized Clinical Trials

VEGF inhibitors in glaucoma surgery

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