Edgar L. Thomas, MD (Beverly Hills, CA),* David S. Boyer, MD (Los Angeles, CA)*

PURPOSE:

To evaluate the efficacy of intravitreous bevacizumab (BV) (Avastin®) blockade of vascular endothelial growth factor (VEGF) in 309 eyes of patients with retinal diseases unresponsive to current therapeutic modalities.

METHODS:

A retrospective study of eyes with macular degeneration (51%), central and branch retinal vein occlusion (15%) diabetic retinopathy (15%) and other complex retinal diseases comprising less than 19% were neovascular glaucoma, perifoveal telangiectasia, nonclearing vitreous hemorrhage (diabetic and non-diabetic), central serous retinopathy, non-arteritic
ischemic optic neuropathy and sarcoid. Eyes were treated with a single intravitreous dose (0.05 ml/1.25 mg) of BV. Clinical improvement determined by better visual acuity reduction in fluorescein angiographic leakage or reductions in retinal thickness on optical coherence tomography were evaluated at 1 week and 1 month.

RESULTS:

More than 92% of the eyes studied in the retrospective review of eyes treated demonstrated at least 2 of 3 parameters of improvement. Improvement was seen within 1 month of injection in following parameters: visual acuity (VA), fluorescein angiographic (FA) reduction in vascular leakage or neovascularization, reduction or regression of iris neovascularization or
reduction in optical coherent tomogram (OCT) retinal thickness measurements.Representative clinical cases will be presented showing these parameters using VAs, fundus photographs, FAs and OCTs for these diseases.

CONCLUSION:

VEGF appears to be ubiquitous as a final common pathway in many retinal diseases and blockade by a specific intravitreous monoclonal antibody (BV) to VEGF has demonstrated potential for therapeutic intervention in multiple retinal diseases when there are no other treatment modalities or they have failed.
* Financial interest disclosed