Intravitreal Bevacizumab During Pregnancy

Abstract

Offering pregnant patients intravitreal bevacizumab therapy during pregnancy for off-label ocular indications can result in significant visual improvement. No adverse events related to treatment occurred in any patient included in this study. Additional studies with more patients and longer follow-up duration are required to identify any risks associated with treatment.

Intravitreal Bevacizumab for a Subfoveal Myopic Choroidal Neovascularization in the First Trimester of Pregnancy

“…7 The other reports showed that patients delivered healthy full-term infants with no documented adverse events related to treatment, and no cases of pregnancy complication in 2 cases of CNV of an origin other than age-related macular degeneration, and in one case of PM-related CNV, respectively. 8,9 Our experience confirms the preliminary results of the previous case reports, reporting an uneventful pre-and postnatal course in a highly myopic woman and her baby. After treatment, visual acuity had favorably improved, with longterm stabilization.…”

“…5 Our knowledge regarding fetus exposure to bevacizumab is based on preclinical studies and limited clinical experience. [6][7][8][9] Preclinical studies in rabbits showed teratogenic effects and an increased number of miscarriages after being intravenously administered bevacizumab. 10 In our case, the patient was administered an intravitreal bevacizumab injection during the first trimester of pregnancy, more specifically at 7 weeks and 3 days of gestation.…”

Ophthalmic agents during pregnancy and breastfeeding

“…Für die Verwendung dieser Substanzen in der Schwangerschaft existieren keine Stu dien, sondern lediglich Einzelfallberichte. Es wird sowohl über unkomplizierte Schwangerschaftsverläufe berichtet als auch über Aborte [19,26,30]. Wir selber haben 2 unauffällige Schwangerschaften unter der Therapie mit Bevacizumab be obachtet.…”

Inadvertent use of bevacizumab in pregnant women with diabetes mellitus type 1

“…However, the use of intravitreal bevacizumab injection (IVB) is gaining wide acceptance as an off-label therapy for a disease that may affect women of childbearing age, as choroidal neovascularization from etiologies other than age-related macular degeneration [1], cystoid macular edema associated with uveitis [1], and diabetic retinopathy [1], particularly diabetic macular edema.…”

“…Bevacizumab is a full-length humanized monoclonal antibody that binds all vascular endothelial growth factor splice variants [1]. Preclinical studies in rabbits showed teratogenic effects and an increased number of miscarriages after intravenous administration of bevacizumab [2].…”