Objective: To describe the role of preoperative intravitreal bevacizumab in patients with tractional retinal detachment undergoing pars plana vitrectomy. Methods: Five eyes of 5 patients with tractional retinal detachment and excessive fibrovascular membrane secondary to proliferative diabetic retinopathy received a single dose of 1.25 mg of intravitreal bevacizumab 5 to 7 days prior to the scheduled pars plana vitrectomy. Pre- and postinjection, intra- and postoperative fundus photos were taken. Intraoperative outcomes were evaluated based on change in the severity of vitreous and intraretinal hemorrhage, change in size of vessel caliber, amount of neovascularization, and the variability of the size of the fibrovascular membrane. Results: The amount of hemorrhage, vessel caliber, neovascularization, and fibrovascular membrane were decreased significantly. Minimal bleeding during dissection of the fibrovascular membrane was noted. Conclusion Intravitreal injection of bevacizumab showed promise as an adjunct in the surgical treatment of tractional retinal detachment secondary to proliferative diabetic retinopathy.
Bevacizumab

No abstract available.
Acneiform Eruptions ; Bevacizumab

Objective: To determine the effect of topically administered bevacizumab on bleb survival and histology after trabeculectomy in rabbit eyes. Methods: This is an experimental interventional comparative animal study. Sixteen rabbit eyes underwent trabeculectomy, 8 of which were enhanced with intraoperative mitomycin-C. Eyes were randomized to receive either topical balanced salt solution (BSS) or topical bevacizumab at a concentration of 12.5 mg/mL. Intraocular pressure, bleb dimensions and vascularity grading were measured. IOP was recorded as a ratio of IOP of the experimental operated eye divided by the IOP of the contralateral control eye (IOPratio) as a function of time. Bleb morphology was recorded as a percentage of the maximum estimated bleb volume (% bleb) as a function of time. Bleb failure occurred if IOPratio ≥0.8, or if % bleb=0. The eyes were then submitted for histopathological analysis after bleb failure has occurred. Results: In plain trabeculectomy, the mean bleb survival in terms of IOP were 6.3 and 9.2 days in the BSS and topical bevacizumab groups respectively (ρ=0.25). In mitomycin-C-enhanced trabeculectomy, the mean bleb survival was 16 and 18.2 days respectively (ρ=0.40). In plain trabeculectomy, mean bleb survival in terms of bleb morphology were 8 and 12.2 days for the BSS and bevacizumab groups respectively (ρ=0.08). In enhanced trabeculectomy, mean bleb survival were 19.5 and 20 days respectively (ρ=0.99). Mean vascularity grading were 2 and 1.9 for the BSS groups, and 1.6 and 1.4 for the bevacizumab groups. Conclusion Topical bevacizumab as adjunctive therapy after trabeculectomy, whether plain or enhanced with mitomycin-C, showed a trend towards prolonged bleb survival, even though the results of this study were not statistically significant.
Bevacizumab ; Trabeculectomy ; Mitomycin

Objectives: Anti-vascular endothelial growth factor (anti-VEGF) drugs delivered intravitreally have been proven effective and safe for the treatment of patients diagnosed with neovascular age-related macular degeneration (ARMD). This study evaluated the short-term biologic efficacy and safety of multiple intravitreal injections of bevacizumab in patients with neovascular ARMD. Methods: A prospective, interventional, placebo-controlled, randomized clinical trial was done involving patients with active subfoveal neovascular ARMD. Excluded were patients with significant media opacity, concomitant retinal/ocular diseases, previous intravitreal injections, recent laser treatment or intraocular surgery, and contraindications to the drug. Demographic data were taken and a complete ocular examination, fluorescein angiogram (FA), and optical coherence tomogram (OCT) were performed. Patients received either 3 monthly intravitreal injections of 1.25mg bevacizumab or sham injections. Best-corrected visual acuity (BCVA) and central macular thickness were recorded at baseline, 2, 4, 8, and 12 weeks follow-up. Ocular/Periocular or systemic drug-related side effects or toxicities and iatrogenic complications were noted. Results: Thirty eyes (15 per group) were included in the final analysis. Both treatment and control groups were comparable in baseline characteristics. There was a significant increase in the mean visual acuity (p < 0.001) in eyes treated with bevacizumab across all time periods. The average gain at the end of the study was 11.6 letters. This paralleled a similar significant decrease in central macular thickness for the treatment group (p < 0.02). No major ocular adverse events were noted. Conclusion This study supported the growing body of evidence that intravitreal injections of bevacizumab 1.25 mg result in short-term anatomical as well as functional improvement with minimal adverse events in patients with neovascular ARMD.
Choroidal Neovascularization ; Macular Degeneration ; Bevacizumab

Background: Neurofibromatosis-2 (NF2) is a rare neurocutaneous syndrome that typically presents with hearing loss, tinnitus, or weakness associated with few subcutaneous nodules. In contrast to neurofibromatosis-1 (NF1), NF2 presents clinically with more central lesions rather than peripheral lesions. The presence of bilateral vestibular schwannomas through imaging studies distinguishes NF2 from other neurocutaneous syndromes. Case: This is a case of an 18-year-old male who presented with lower paraparesis with associated hearing loss, cataract, and a few subcutaneous nodules. Centrally located lesions were suspected, thus brain and spine magnetic resonance imaging (MRI) were done revealing bilateral vestibular schwannomas and spine neurofibromas. The patient and family were advised for tumor surveillance, and apprised of surgical intervention once with brainstem compression symptoms. Conclusion NF2 is a rare debilitating disease that may lead to multiple neurologic deficits. The absence of recommended medical treatment and the multifocality of the tumors leave surgical resection a high-risk treatment option. Early recognition by tumor surveillance may give patients with NF2 a better prognosis and survivability.
Neurofibromatoses ; Neurilemmoma ; Neurofibroma ; Paraparesis ; Bevacizumab

PURPOSE: Bevacizumab±irinotecan is effective for treatment of recurrent malignant gliomas. However, the optimal duration of treatment has not been established. MATERIALS AND METHODS: Ninety-four consecutive patients with recurrent malignant glioma who were treated with bevacizumab at our institutions were identified. Patients who continued bevacizumab until tumor progression were enrolled in a late discontinuation (LD) group, while those who stopped bevacizumab before tumor progression were enrolled in an early discontinuation (ED) group. Landmark analyses were performed at weeks 9, 18, and 26 for comparison of patient survival between the two groups. RESULTS: Among 89 assessable patients, 62 (69.7%) and 27 (30.3%) patients were categorized as the LD and ED groups, respectively. According to landmark analysis, survival times from weeks 9, 18, and 26 were not significantly different between the two groups in the overall population. However, the LD group showed a trend toward increased survival compared to the ED group among responders. In the ED group, the median time from discontinuation to disease progression was 11.4 weeks, and none of the patients showed a definite rebound phenomenon. Similar median survival times after disease progression were observed between groups (14.4 weeks vs. 15.7 weeks, p=0.251). Of 83 patients, 38 (45.8%) received further therapy at progression, and those who received further therapy showed longer survival in both the LD and ED groups. CONCLUSION: In recurrent malignant glioma, duration of bevacizumab was not associated with survival time in the overall population. However, ED of bevacizumab in responding patients might be associated with decreased survival.
Bevacizumab* ; Disease Progression ; Glioblastoma ; Glioma* ; Humans

No abstract available.
Antibodies, Monoclonal, Humanized ; Bevacizumab ; Cyclophosphamide ; Ovarian Neoplasms

Objectives This study determined the biologic effect and safety of subconjunctival administration of bevacizumab in patients with primary and recurrent pterygium. Methods We conducted an off-label, multiple-dosing, interventional case series involving 15 patients with primary and recurrent pterygium. They received subconjunctival bevacizumab (1.25 mg) every 2 weeks for 10 weeks. Pterygium vascularity and thickness were graded (1 for atrophic, 2 for intermediate, and 3 for fleshy) by 3 masked observers. The size of the pterygium (measured by surface area in cm2) was recorded from baseline to 16 weeks postinjection. Treatment-related complications and adverse events were reported. The main outcome measures were changes in pterygium size, vascularity, thickness, and treatment safety. Results There was no statistically significant difference in the mean surface area of the pterygia at different intervals (p > 0.05). The mean surface area was 1.22 ± 0.19 cm2 at baseline, 1.22 ± 0.18 cm2 and 1.22 ± 0.17 cm2 at 10 and 16 weeks postinjection respectively. There was a significant difference in the mean pteygium grading by the 3 masked observers at different intervals (p < 0.01). At baseline, there were 11 patients (73.3%) with grade 2 pterygium and 4 (26.7%) with grade 3. At 1.5 months postinjection, there were 5 (33.3%) with grade 1 pterygium, 7 (46.7%) with grade 2, and 3 (20%) with grade 3. The 5 patients with grade 1 pterygium at the end of the study period had a baseline pterygium grading of 2. Snellen visual acuity, refraction, intraocular pressure, and blood pressure remained stable. No serious ocular or systemic side effects were observed. Conclusion Subconjunctival injection of 1.25 mg of bevacizumab given every 2 weeks for 10 weeks resulted in no significant change in size of the pterygium. However, local application of bevacizumab showed promise in inducing regression in pterygium vascularity and thickness. Further evaluation of bevacizumab for the treatment of pterygia is warranted.
Pterygium ; Vascular Endothelial Growth Factor A ; Bevacizumab

No abstract available.
Bevacizumab ; Intravitreal Injections ; Macular Edema ; Retinal Perforations

PURPOSE: To observe the degree of damage in a 30-gauge injection needle by observing the changes in needle tip following an intravitreal injection with the use of a scanning electron microscope. METHODS: The present study evaluated 11 injection needles collected following the use of an intravitreal injection of bevacizumab. Ten unused injection needles were selected as the control group. Needle examination was performed using a scanning electron microscope. RESULTS: Following 11 intravitreal injections, seven bent needle tips, two stubbed needle tips and two almost normal needle tips were observed following intravitreal injections. In the control group, a single damaged needle tip was observed. CONCLUSIONS: Significant damage to the needle tip was observed following intravitreal injection using a 30-gauge injection needle. The results indicate that needles should be manipulated carefully during an intravitreal injection. Additionally, in the control group where no procedures were performed, a single injection needle with damaged status was found. These results indicate that needles should be replaced in cases in which resistance is perceived during the procedure.
Antibodies, Monoclonal, Humanized ; Electrons ; Intravitreal Injections ; Microscopy, Electron ; Needles ; Bevacizumab