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Chunzhi Dou, Willie Chen, Stanley Wu, Xuewen Zhang, Shunyan Gu, Tiehua Dou; Avastin Continuous Low Rate Infusion through Minipump Limited Diabetic Retinopathy in Poorly Controlled Diabetic SD Rats. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1064.
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© ARVO (1962-2015); The Authors (2016-present)
The objective of current study is to explore a new approach using Alzet minipump continuous low dose infusion of Avastin to prevent diabetic retinopathy in hyperglycemic SD rats, aiming to point a direction of clinical management of poorly controlled diabetic patients and to lower the risk of diabetic retinopathy development.
The current research project was conducted in compliance with the ARVO Statement for the Use of Animals in Ophthalmic and Vision Research. The diabetic rat model was made by intraperitoneal injection of Streptozotocin (STZ). One week after the injection blood glucose was measured through tail veins. Insulin was injected daily with adjusting dose to maintain blood glucose at the level of 250mg/dl. Rats were divided into three groups: group A received surgical implanted Avastin-preloaded minipump, the catheter tip is measured 3mm from the sclera so it stayed in vitreous cavity; group B received Avastin single intravetreal injection (0.125mg); group C received saline intravetreal injection. IOP was measured within 30 minutes after the surgery or injection and daily at the same time. The blood glucose and body weight was measured daily, HbA1C was monitored weekly. At the end of experiment, rats were euthanized and eyes were enucleated for diabetic retinopathy evaluation.
Blood glucose was maintained in the range of 240-250mg/dl, while body weight continously decreased during the experiment for three groups. HbA1c started to elevated at the second week of all the groups. Two (n-10) rats in saline injection group had elevated IOP; 3 (n=10) rats in Avastin injection group developed elevated IOP; rats received Avastin continuous infusion had normal IOP through the whole study course. One rat in saline group and 2 rats in Avastin intravitreal injection group developed infection. In terms of diabetic retinopathy, one in saline group developed PDR, one in the same group developed NPDR, 4 developed mild NPDR. No PDR developed in Avastin groups either through one time injection or continuous infusion; one in Avastin intravitreal injection group developed mild NPDR.
From our preliminary study we concluded that Avastin continuous infusion through minipump achieved better clinical outcome in terms of preventing diabetic retinopathy and minimized side effect of Avastin intravitreal injection such as elevated IOP and endopthalmitis.
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