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A. Giuliano, R. E. P. Frenkel, R. Avery, G. Thomas, A. R. Toler, M. P. C. Frenkel; Contralateral Effect from Intravitreal Avastin for the Treatment of Wet AMD. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3365.
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To report the effect of intravitreal Avastin injection in thecontralateral eye of 3 cases of PDR and 5 cases of AMD. It hasbeen observed in 2 eyes with PDR that there may be a contralateraleffect1, and Avastin has been recovered in a contralateral rabbiteye.2
All patients had visual acuity, OCT, and fluorescein angiographydone before and after treating patients with 1.25 to 2.5 mgof intravitreal Avastin.
In the PDR patients, one had resolution of NVD, and 2 had improvementin rubeosis. In AMD, 3 had improved OCTs in fellow eye and twohad increased vision. One patient, an 82 y.o. WF, with bilateralCNV that had less subretinal fluid (SRF) OS than OD received(1.25mg), in the better seeing OS: average OCT thickness inthe elevated areas were 305 OD and 311 OS prior to treatment.Avastin resulted in a reduction in SRF OS, but more so OD. AverageOCT thickness in the elevated areas 3 weeks after treatmentwere 243 OD and 255 OS (p-value = 0.02 OD; 0.08 OS). The areaof SRF OD when measured on the OCT scanned image with customsoftware decreased from 2.65 µm2 (top image) to 0.5 µm2(bottom image) for an 81% reduction.
This contralateral effect is suggestive that Avastin has a systemicinhibitory effect. Evaluation of intravitreal doses lower than1.25 mg is warranted. Substantially lower intravenous dosesthan 5mg/kg might also be effective if they are safe.
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