Combined Intravitreal Bevacizumab and Laser Photocoagulation to Treat Retinal Arterial Macroaneurysms

Purpose: To investigate the effects of intravitreal bevacizumab injection combined with laser photocoagulation in patients with retinal microaneurysms.Methods: We retrospectively reviewed the medical records of 21 eyes of 21 patients who underwent intravitreal bevacizumab injection and/or laser photocoagulation to treat retinal macroaneurysms. Eleven eyes received the combination therapy (CT) and 10 eyes monotherapy (MT) (either bevacizumab injection or laser photocoagulation). Changes in visual acuity, central macular thickness, macroaneurysm size and location, blood pressure, and the lipid level were compared between the two groups.Results: The mean patient age was 74.0 ± 10.5 years and the mean study period 7.0 ± 5.3 months. The mean macroaneurysm diameter of the CT group was 480.00 ± 292.30 μm and that of the MT group 328.75 ± 87.09 μm. The diameter was significantly larger in the CT group (p = 0.002). The initial visual acuities were 0.91 ± 0.66 and 0.88 ± 0.83 in the CT and MT groups, respectively. At the 4-month follow-up, the visual acuities were 0.33 ± 0.26 and 0.17 ± 0.29 in the CT and MT groups, respectively, and had significantly improved only in the CT group (p = 0.042). The initial central macular thicknesses were 441.82 ± 226.81 and 541.63 ± 401.97 μm in the CT and MT groups, respectively. At the 4-month follow-up, the figures were 293.60 ± 46.10 and 269.00 ± 48.34 μm in the CT and MT groups, respectively, and had significantly decreased only in the CT group (p = 0.043). Compared to the initial findings, the proportion of patients whose final visual acuities improved by more than two lines were 73% and 40%, respectively, thus significantly higher in the CT group (p < 0.001).Conclusions: Combined intravitreal bevacizumab injection and laser photocoagulation treatment of retinal macroaneurysms improve visual acuity and decrease macular thickness.

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Can an Intraoperative Bevacizumab Injection Prevent Recurrent Postvitrectomy Diabetic Vitreous Hemorrhage?

European Journal of Ophthalmology ◽

10.1177/112067210901900416 ◽

2009 ◽

Vol 19 (4) ◽

pp. 618-621 ◽

Cited By ~ 20

Author(s):

Mario R. Romano ◽

Syed Khurshid Gibran ◽

Joaquin Marticorena ◽

David Wong ◽

Henrich Heimann

Keyword(s):

Visual Acuity ◽

Pars Plana Vitrectomy ◽

Intravitreal Bevacizumab ◽

Vitreous Hemorrhage ◽

Diabetic Patients ◽

Intravitreal Bevacizumab Injection ◽

Pars Plana ◽

Grade 3 ◽

Bevacizumab Injection

Purpose To evaluate the recurrence of vitreous hemorrhage (VH) in patients treated with intravitreal bevacizumab (IVB) injection (2.5 mg/0.1 mL) intraoperatively at the end of vitrectomy for treatment of diabetic nonclearing VH. Methods A prospective pilot study of 30 eyes of 28 consecutive diabetic patients who underwent pars plana vitrectomy and IVB injection intraoperatively at the end of vitrectomy was performed. The amount of VH was graded with slit lamp biomicroscopy by three masked retinal specialists from grade 0 to grade 3. Main outcome measures were rate of recurrence of the VH, improvement in visual acuity, incidence of cataract formation, and postoperative complications through a follow-up of 6 months. Results The percentage of severe recurrent VH with no fundus details (grade 3) was 7%, 13%, 27%, and 30%, respectively, at 7 days and 1-, 3-, and 6-month follow-up. At 6-month follow-up, the best-corrected visual acuity improved from 1.00 to 0.4 logMAR (p=0.01) in 21 out of 30 eyes (70%). Nine out 20 (40%) phakic patients developed cataract during the follow-up period, and 7 (31%) of them underwent cataract surgery. Conclusions The study suggests that intravitreal bevacizumab injection cannot prevent rebleeding in eyes undergoing pars plana vitrectomy for treatment of diabetic vitreous hemorrhage.

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Functional and structural outcome after vitrectomy combined with subretinal rtPA Injection with or without additional intravitreal Bevacizumab injection for submacular hemorrhages

PLoS ONE ◽

10.1371/journal.pone.0250587 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250587

Author(s):

Annekatrin Rickmann ◽

Lina R. Paez ◽

Maria della Volpe Waizel ◽

Lukas Bisorca-Gassendorf ◽

André Schulz ◽

...

Keyword(s):

Visual Acuity ◽

Case Series ◽

Intravitreal Bevacizumab ◽

Age Related Macular Degeneration ◽

Subretinal Space ◽

Intravitreal Bevacizumab Injection ◽

Age Related ◽

The Mean ◽

Group B ◽

Bevacizumab Injection

Background To analyze the functional and anatomical outcome after vitrectomy with subretinal rtPA (recombinant tissue plasminogen activator) combined with or without an intravitreal Bevacizumab injection. Patients and methods Retrospective, consecutive case series of 31 pseudophakic patients with submacular hemorrhage (SMH) due to neovascular age-related macular degeneration (AMD) treated with vitrectomy, subretinal rtPA and pneumatic air displacement with or without an additional intravitreal Bevacizumab injection. The primary endpoints were best-corrected visual acuity (BCVA), and central macular thickness (CMT) measured by SD‑OCT. The secondary endpoint was a displacement of hemorrhage from the subretinal space three months after surgery. Results 31 eyes of 31 patients were treated with vitrectomy and subretinal rtPA. 17/31 were treated simultaneously with an intravitreal Bevacizumab injection (group +B) and 14/31 without (group -B). The mean visual acuity improved significantly in both groups (from 1.37±0.39 to 1.03±0.57 logMAR in +B and from 1.48±0.48 to 1.01±0.38 logMAR in group –B, p<0.05). The mean CMT decreased in group +B from 607±179 μm to 424±205 μm (p = 0.2) and in group –B from 722±216 μm to 460±202 μm (p<0.05). A central displacement of the hemorrhage could be achieved in 47% in group +B, whereas in group -B displacement could be achieved in 50% (p = 0.44). Conclusions Vitrectomy with subretinal rtPA injection and air tamponade with or without simultaneous intravitreal Bevacizumab injection displaces SMH and improves BCVA effectively. In comparison, the postoperative outcome is comparable regardless of whether or not intravitreal bevacizumab is applied simultaneously.

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Serial Intravitreal Bevacizumab Injections Slow the Progression of Radiation Maculopathy Following Iodine-125 Plaque Radiotherapy

The Open Ophthalmology Journal ◽

10.2174/1874364101610010103 ◽

2016 ◽

Vol 10 (1) ◽

pp. 103-110 ◽

Cited By ~ 3

Author(s):

Andrew W. Stacey ◽

Hakan Demirci

Keyword(s):

Visual Acuity ◽

Fluorescein Angiography ◽

Late Phase ◽

Treatment Strategies ◽

Choroidal Melanoma ◽

Intravitreal Bevacizumab ◽

Intravitreal Bevacizumab Injection ◽

Plaque Radiotherapy ◽

The Mean ◽

Bevacizumab Injection

Background and Objective: To assess the outcomes of intravitreal bevacizumab injection in the management of radiation maculopathy secondary to plaque radiotherapy, and to identify optimal treatment strategies. Study Design: A retrospective review of all choroidal melanoma patients at one referral center who were treated with plaque radiotherapy, subsequently developed radiation maculopathy, and received intravitreal bevacizumab. Results: A total of 31 patients were identified. The mean visual acuity decreased three Snellen lines in the year leading up to the first bevacizumab injection. After initiating injection therapy, the mean visual acuity remained stable for 9 months. The change in visual acuity of patients who received injections within 90 days of previous injections was significantly better than the visual acuity of those who received injections more than 90 days apart (p=0.0003). Patients who demonstrated late-phase macular leakage on fluorescein angiography at the time of the first bevacizumab injection had better long-term visual acuity outcomes than patients who had no evidence of macular leakage (average of one line improvement of vision vs. ten line loss of vision, p=0.03). Conclusions: Intravitreal bevacizumab injection was effective in stabilizing visual acuity in patients with radiation maculopathy. Patients benefited most from injections administered every 90 days or sooner. Fluorescein angiography can help identify patients who will respond favorably to treatment.

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Evaluation of Intravitreal Bevacizumab injection in treatment of diabetic macular edema in eyes with Good visual acuity

10.21203/rs.3.rs-36672/v1 ◽

2021 ◽

Author(s):

seyed aliasghar mosavi

Keyword(s):

Visual Acuity ◽

Treatment Group ◽

Macular Edema ◽

Intravitreal Bevacizumab ◽

Macular Thickness ◽

Control Group ◽

The Mean ◽

The Difference ◽

Good Vision

Abstract Aims To determine the effect of intravitreous Bevacizumab injection on reducing diabetic macular edema in patients with good vision. Method : This clinical trial was conducted on diabetic patients with centrally involved macular edema and good vision over a period of one and a half year. 22 eyes of 12 patients with a visual acuity of Snellen equivalent of 20/25 or better in the non-proliferative stage with the central macular thickness of more than 300 microns in optical coherence tomography (OCT) were evaluated. In the injection group 1.25 Mg of bevacizumab (Avastin) was injected intravitreally and the control group was followed up. Macular thickness and visual acuity were measured in two groups at first and sixth months after injection. Results Intravitreal bevacizumab was injected in 12 eyes (55%) and 10 patients were followed-up as a control group (45%). The mean central macular thickness was 319 µm at first visit and 301 µm at month six in the treatment group and in the control group it was 318 µm and 328 µm respectively. The mean macular thickness of the treatment group was significantly decreased (p = 0.031), but the difference was not statistically significant between two groups (p = 0.581). The mean visual acuity in the treatment group was 0.045 Log MAR at first visit and 0.033 Log MAR at the sixth month follow up, these values in the control group were 0.1 Log MAR and 0.045 Log MAR respectively and did not differ statistically between the two groups (p = 0.373) Conclusion Although the mean macular thickness was reduced in the treatment group with visual acuity of 20/25 or better but the difference was not significant during follow-up at least in a short period. Therefore, the role of underlying factors other than VEGF alone can be notable in the pathogenesis of the disease.

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Evaluation of Ellipsoid Zone Changes in Different Types of Diabetic Macular Edema After Intravitreal Bevacizumab Injection

10.21203/rs.3.rs-1011438/v1 ◽

2021 ◽

Author(s):

Utku Limon ◽

Betul Ilkay Sezgin Akcay

Keyword(s):

Macular Edema ◽

Diabetic Macular Edema ◽

Intravitreal Bevacizumab ◽

Inclusion Criteria ◽

Ellipsoid Zone ◽

Intravitreal Bevacizumab Injection ◽

Group 4 ◽

The Mean ◽

Bevacizumab Injection

Abstract Purpose: To evaluate the ellipsoid zone (EZ) changes according to the types of diabetic macular edema (DME) on optical coherence tomography (OCT) after intravitreal bevacizumab injection. Methods: In this retrospective study, medical records of the patients who had treatment-naive DME and underwent intravitreal bevacizumab treatment between January 2015 and December 2021 were analyzed. Patients who meet the inclusion criteria and completed the follow-up period of 12 months were divided into 4 groups according to the types of diabetic macular edema on OCT (Diffuse DME [Group-1], cystoid DME [Group-2], diffuse DME with serous retinal detachment (SRD) [Group-3] and cystoid DME with SRD [Group-4]). Primary outcomes were EZ changes between the groups.Results: 125 eyes of 96 patients who fulfilled the inclusion criteria and completed the follow-up period were included in the study. There were no statistically significant differences in EZ improvements between the groups at 4, 6 and 12 months after treatment (p =0,594, p=0,836, p=0,486, p=0,748 respectively). The mean logMAR BCVA and CMT of all eyes showed significant improvement at 4, 6 and 12 months. When the mean CMT was compared between each groups, there were significant differences between the Group-1and Group-4 at 4, 6 and 12 months after treatment. (p<0,05)Conclusion: The BCVA gains and improvement in the CMT were maintained in all four DME types during the first year of intravitreal bevacizumab therapy. The improvement in EZ disruption was not depent on the type of DME and improved similarly in all groups.

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The Effects of Intravitreal Bevacizumab in Infectious and Noninfectious Uveitic Macular Edema

Journal of Ophthalmology ◽

10.1155/2014/729465 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 12

Author(s):

Hassan Al-Dhibi ◽

Issam H. Hamade ◽

Ali Al-Halafi ◽

Maan Barry ◽

Charbel Bou Chacra ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Case Series ◽

Intravitreal Bevacizumab ◽

Macular Thickness ◽

Ocular Tuberculosis ◽

Intravitreal Bevacizumab Injection ◽

Uveitic Macular Edema ◽

Infectious Uveitis ◽

The Mean

Background/Aims.To assess the effect of intravitreal bevacizumab injection (IVBI) for the treatment of macular edema due to infectious and noninfectious uveitides.Design.Retrospective interventional case series.Methods.A chart review was performed on all the patients who were diagnosed with uveitic macular edema (UME) and received 1.25 mg of IVBI at two referral centers in Riyadh, Saudi Arabia. All included patients had their visual acuity and macular thickness analyzed at baseline and at 1 and 3 months following IVBI and any sign of reactivation was noted.Results.The mean age of patients was41±16years with a mean followup of4±1months. Ten patients had idiopathic intermediate uveitis, 9 patients had Behcet’s disease, 10 had idiopathic panuveitis, and twelve patients had presumed ocular tuberculosis uveitis. Following IVBI, the mean LogMAR visual acuity improved from0.8±0.8at baseline to0.4±0.5at 1 month and0.3±0.5at 3 months (P<0.002, at 3 months). The mean macular thickness was430±132 μm at baseline. Following IVBI macular thickness improved to286±93 μm at 1 month and to265±88 μm at 3 months of followup (P<0.001, at 3 months).Conclusion.Bevacizumab was effective in the management of UME associated with both infectious and noninfectious uveitides. Intravitreal bevacizumab induced remission of UME with infectious uveitis and had no immunosuppressive effect against infectious agents.

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Intravitreal Bevacizumab in Refractory Uveitic Macular Edema: One-year Follow-up

European Journal of Ophthalmology ◽

10.1177/112067210901900417 ◽

2009 ◽

Vol 19 (4) ◽

pp. 622-629 ◽

Cited By ~ 34

Author(s):

Rene A. Cervantes-Castañeda ◽

Gian Paolo Giuliari ◽

Michael J. Gallagher ◽

Taygan Yilmaz ◽

Rebecca E. Macdonell ◽

...

Keyword(s):

Visual Acuity ◽

Combination Therapy ◽

Macular Edema ◽

Triamcinolone Acetonide ◽

Intravitreal Bevacizumab ◽

Central Macular Thickness ◽

Intravitreal Bevacizumab Injection ◽

Uveitic Macular Edema ◽

The Mean ◽

Bevacizumab Injection

Purpose Uveitis is a major cause of ocular morbidity in developed countries. It has been demonstrated that macular edema is a significant cause of decreased visual acuity and macular edema in these patients. In this article, we evaluate the long-term outcome of intravitreal bevacizumab in the treatment of refractory uveitic macular edema. Methods In this retrospective, noncomparative, interventional case series, uveitic patients with macular edema who were refractory to conventional therapy and who were treated with intravitreal bevacizumab were identified and assessed. Best-corrected visual acuity and optical coherence tomography central macular thickness measurements were collected and analyzed with correlative statistical analysis, including the use of Student paired t-test, Kaplan-Meier, and linear regression analysis. Results Twenty-nine eyes of 27 patients with diverse uveitic etiologies were analyzed and followed up at 1 year. Thirteen patients received a single intravitreal bevacizumab injection. Six patients required a second intravitreal bevacizumab injection, while 10 patients received combination therapy of intravitreal bevacizumab and triamcinolone acetonide. Baseline mean logMAR visual acuity was −0.59. At 1 year, the mean logMAR visual acuity was −0.42± 0.36 (p=0.0045). Baseline mean central macular thickness was 383.66 μm. At 1 year, the mean thickness was 294.32±110.87 (p=0.0007). Conclusions Intravitreal bevacizumab is a useful and therapeutically beneficial agent in the treatment of refractory uveitic macular edema. Some patients will require adjunctive intravitreal bevacizumab injections or the use of combination therapy with intravitreal triamcinolone acetonide.

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