Primary Intravitreal Bevacizumab (Avastin) for Diabetic Macular Edema

Arévalo, J. Fernando; Fromow-Guerra, Jans; Quiroz‐Mercado, Hugo; Sánchez, J. García; Wu, Lihteh; Maia, Maurício; Berrocal, María H.; Solis-Vivanco, A.; Farah, Michel Eid

doi:10.1016/j.ophtha.2006.12.028

Cited by 301 publications

(86 citation statements)

References 30 publications

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“…2007). However, our subgroup analyses did not show obvious and robust differences among the DME subgroups, which might be due to the small sample sizes.…”

Section: Discussionmentioning

confidence: 99%

The RELATION study: efficacy and safety of ranibizumab combined with laser photocoagulation treatment versus laser monotherapy in NPDR and PDR patients with diabetic macular oedema

Lang

Liakopoulos

Vögeler

et al. 2017

Acta Ophthalmologica

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PurposeTo assess efficacy and safety of intravitreal ranibizumab 0.5 mg plus laser (COMBI) versus laser monotherapy (LASER) in patients with visual impairment due to diabetic macular oedema (DME) in either nonproliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) and to analyse the relevance of inner versus outer retinal thickness.MethodsIn this double‐masked, multicentre phase IIIb study, patients (N = 128) were randomized (2:1) to receive COMBI (n = 85) versus LASER (n = 43). Patients received four initial monthly injections of ranibizumab 0.5 mg (COMBI) or sham (LASER) followed by pro re nata (PRN) injections. In both groups, patients received laser at baseline and additional laser at 3 monthly intervals, as needed. The study was started in 2010 and was prematurely terminated due to approval of ranibizumab for DME.ResultsThe least squares (LS) mean change in mean best‐corrected visual acuity (BCVA) from baseline to month 12 was higher in the COMBI (6.5) versus LASER (2.3) group (LS mean difference: 4.2 [95% CI 0.9; 7.4] letters, p = 0.01, primary end‐point). There was also a tendency in the same direction for the subgroup of 26 patients with PDR (LS mean difference 14.7, p = 0.11). Mean central retinal thickness decreased by 107.3 μm in the COMBI group and by 80.3 μm in the LASER group from baseline to month 12 (p = 0.28). Ranibizumab was well tolerated.ConclusionThis study showed that ranibizumab plus laser is a valuable treatment option for the management of DME. Patients with DME in PDR might also benefit from combined therapy compared to laser alone.

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“…2007). However, our subgroup analyses did not show obvious and robust differences among the DME subgroups, which might be due to the small sample sizes.…”

Section: Discussionmentioning

confidence: 99%

The RELATION study: efficacy and safety of ranibizumab combined with laser photocoagulation treatment versus laser monotherapy in NPDR and PDR patients with diabetic macular oedema

Lang

Liakopoulos

Vögeler

et al. 2017

Acta Ophthalmologica

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“…1,3,4 Although many studies have investigated the elevation of IOP and BP after intravitreal bevacizumab, 12,13,15,16 none has evaluated its effects on BP in relation to the specific ocular pathology present. The mechanism by which inhibition of VEGF induces hypertension is unclear, but a recent study reported that endothelial dysfunction and capillary rarefaction are closely associated with the observed increase in BP.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] The pathologic mechanisms of these diseases differ in detail, but many studies have indicated that vascular endothelial growth factor (VEGF) has an important function in ocular neovascularization. 5,6 Data have been obtained implicating VEGF in the pathologic vascular growth seen in DR, retinal vein occlusion, iris neo-vascularization, and age-related macular degeneration (AMD).…”

Section: Introductionmentioning

confidence: 99%

Blood pressure changes after intravitreal bevacizumab in patients grouped by ocular pathology

Younghae

Lee

Cho

et al. 2010

Eye

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Purpose We evaluated the effects of intravitreal injection of bevacizumab (Avastin; Novartis, Basel, Switzerland) on blood pressure (BP) in the context of ocular vascular pathology. Methods This study retrospectively examined 135 consecutive patients treated with intravitreal injections of 1.25 mg bevacizumab for retinal vascular disease; there were 61 cases of diabetic retinopathy, 30 of retinal vein occlusion, 35 of choroidal neo-vascularization (CNV), and 9 of other retinal vascular diseases. BP was measured before injection and at 30 min, 1 day, 1 week, 3 weeks, and thereafter monthly over a 6-month period. Results In the CNV group, 30-min postinjection systolic values were significantly higher than baseline, and systolic and diastolic values after 1 day, 1 week, and 3 weeks were significantly lower than before injection. No other pressure measurement differed significantly from baseline values in the other groups. Discussion Intravitreal bevacizumab injection is safe in terms of its effect on BP, regardless of ocular pathology.

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“…Динамика остроты зрения и толщины сетчатки была сходной при введении обеих доз. Побочные эффекты включали транзиторное повы-шение артериального давления (1 случай), внутриглазного давления (1 глаз), тракционную отслойку сетчатки (1 слу-чай) [33,34].…”

Section: бевацизумабunclassified

Anti-VEGF agents in the treatment of diabetic macular edema

Иосифович²,

Климонтов

et al. 2013

Diabetes mellitus

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Diabetic macular edema (DME) is a common complication associated with the loss of visual acuity in diabetic patients. Intravitreal injections of vascular endothelium growth factor (VEGF) inhibitors (anti-VEGF therapy) have been proposed recently as a new treatment option for patients with DME. In this review we summarized results of randomized clinical trials of VEGF inhibitors in DME patients. The results indicate that all studied inhibitors (ranibizumab, bevacizumab, pegaptanib and aflibersept) reduce the retinal thickness and improve of visual acuity in DME when are used as a monotherapy or in combination with the laser treatment. Optimal course duration and effectiveness predictors of anti-VEGF therapy in DME should be elucidate in the future studies.

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Primary Intravitreal Bevacizumab (Avastin) for Diabetic Macular Edema

Cited by 301 publications

References 30 publications

The RELATION study: efficacy and safety of ranibizumab combined with laser photocoagulation treatment versus laser monotherapy in NPDR and PDR patients with diabetic macular oedema

The RELATION study: efficacy and safety of ranibizumab combined with laser photocoagulation treatment versus laser monotherapy in NPDR and PDR patients with diabetic macular oedema

Blood pressure changes after intravitreal bevacizumab in patients grouped by ocular pathology

Anti-VEGF agents in the treatment of diabetic macular edema

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