We studied the effect of an intracameral bevacizumab injection on the corneal endothelium and iris neovessels (INV).
Methods:
Ten eyes were studied in 10 patients with an average age of 52.1 ± 13.17 years. Patients underwent intracameral bevacizumab injections at a concentration of 1.25 mg/0.05 mL. Intraocular pressure, best-corrected visual acuity, gonioscopy, neovascular membrane extent, anterior segment photography, iris fluorescein angiography, pachymetry, and specular microscopy were recorded preoperatively and postoperatively.
Results:
The minimum follow-up period was 4 months. INVs started to regress within the first 2 days after the injection and regressed completely by the end of the fourth week. Reduction in INV leakage started 1 week after injection, and resolved in 8 eyes (80%) by the end of the fourth week. Intraocular pressure dropped significantly from 17.8 ± 4.8 mmHg to 16.6 ± 2.8 mmHg over 4 weeks. The mean endothelial cell loss was 3.95% ± 6.78%.
Conclusions:
An intracameral bevacizumab injection proved to be safe for corneal endothelial cells.
AmanoS., RohanR., KurokiM., et al.Requirement for vascular endothelial growth factor in wound-and inflammation-related corneal neovascularization. Invest. Ophthalmol. Vis. Sci. 39:. 18–22,, 1998.
3.
AdamisA.P., ShimaD.T., TolentinoM., et al.Inhibition of VEGF prevents retinal ischemia-associated iris neovascularization in a primate. . Arch Ophthalmol. 114:66–71, 1996.
4.
DvorakH.F., BrownL.F., DetmarM., et al. Vascular permeability factor/vascular endothelial growth factor, microvascular hyperpermeability, and angiogenesis. Am. J. Pathol. 146:1029–1039, 1995.
5.
D’AmoreP.A. Mechanisms of retinal and choroidal neovascularization. Invest. Ophthalmol. Vis. Sci. 35:3974–3979, 1994.
6.
CiullaT.A., and RosenfeldP.J. Anti-vascular endothelial growth factor therapy for neovascular ocular diseases other than age-related macular degeneration. Curr. Opin. Ophthalmol. 20:166–174, 2009.
7.
GrisantiS., BiesterS., PetersS., etal. The Tuebingen Bevacizumab Study Group. Intracameral bevacizumab for iris rubeosis. Am. J. Ophthalmol. 142:158–160, 2006.
8.
DuchS., BuchacraO., MillaE., et al. Intracameral bevacizumab (Avastin) for neovascular glaucoma: a pilot study in 6 patients. J. Glaucoma. 18:140–143, 2009.
9.
FerraraN., HillanK.J., and NovotnyW. Bevacizumab (Avastin), a humanized anti-VEGF monoclonal antibody for cancer therapy. Biochem. Biophys. Res. Commun. 333:328–335, 2005.
10.
ZakarijaA., and SoffG. Update on angiogenesis inhibitors. Curr. Opin. Oncol. 17:578–583, 2005.
11.
NgE.W.M., and AdamisA.P. Targeting angiogenesis, the underlying disorder in neovascular age-related macular degeneration. Can. J. Ophthalmol. 40:353–368, 2005.
12.
TeichS.A., and WalshJ.B. A grading system for iris neovascularization. Prognostic implications for treatment. Ophthalmology. 88:1102–1106, 1981.
13.
EhrenbergM., McCuenB.W.II, SchindlerR.H.. et al. Rubeosis iridis: preoperative iris fluorescein angiography and periocular steroids. Ophthalmology. 91:321–325, 1984.
14.
MichaelsonI.C. The mode of development of the vascular system of the retina, with some observations on its significance for certain retinal diseases. Trans. Ophthalmol. Soc. U.K. 68:137–180, 1948.
15.
Sivak-CallcottJ.A., O’DayD.M., GassJ.D., et al. Evidence-based recommendations for the diagnosis and treatment of neovascular glaucoma. Ophthalmology. 108:1767–1776, 2001.
16.
TripathiR.C., LiJ., TripathiB.J., etal. Increased level of vascular endothelial growth factor in aqueous humor of patients with neovascular glaucoma. Ophthalmology. 105::232–237, 2001.
17.
GregoriN.Z., GaitanJ., RosenfeldP.J., etal. . Long-term safety and efficacy of intravitreal bevacizumab (Avastin) for the management of central retinal vein occlusion. Retina. 28:1325–1337, 2008.
18.
AveryR.L., PearlmanJ., PieramiciD.J., et al. Intravitreal bevacizumab (Avastin) in the treatment of proliferative diabetic retinopathy. Ophthalmology. 113: 1695.e1–15, 2006.
19.
IlievM.E., DomigD., and Wolf-SchnurrburschU. Intravitreal bevacizumab (Avastin) in the treatment of neovascular glaucoma. Am. J. Ophthalmol. 142:1054–1056, 2006.
20.
GroverS., GuptaS., SharmaR., et al. Intracameral bevacizumab effectively reduces aqueous vascular endothelial growth factor concentrations in neovascular glaucoma. Br. J. Ophthalmol. 93:273–274, 2009.
21.
ChalamK.V., GuptaS.K., GroverS., et al. Intracameral Avastin dramatically resolves iris neovascularization and reverses neovascular glaucoma. Eur. J. Ophthalmol. 18:255–262, 2008.
22.
ParkH.Y., KimS.J., LeeH.B., et al. Effect of intracameral bevacizumab injection on corneal endothelium in rabbits. Cornea. 27:1151–1155, 2008.
23.
ChilovM.N., GriggJ.R., and PlayfairT.J. Bevacizumab (Avastin) for the treatment of neovascular glaucoma. Clin. Experiment. Ophthalmol. 35:494–496, 2007.
24.
AlióJ.L., MuletM.E., ShalabyA.M., et al. Phacoemulsification in the anterior chamber. J. Cataract. Refract. Surg. 28:67–75, 2002.
25.
Baradaran-RafiiA., Rahmati-KamelM., EslaniM., et al. Effect of hydrodynamic parameters on corneal endothelial cell loss after phacoemulsification. J. Cataract Refract. Surg. 35:732–737, 2009.
26.
Storr-PaulsenT., NorregaardJ.C., AhmedS., etal. Corneal endothelial cell loss after mitomycin C-augmented trabeculectomy. J. Glaucoma. 17:654–657, 2008.
27.
KimC.S., YimJ.H., LeeE.K., et al. Changes in corneal endothelial cell density and morphology after Ahmed glaucoma valve implantation during the first year of follow up. Clin. Experiment. Ophthalmol. 36:142–147, 2008.
