Potential Adverse Events Associated With Intravitreal Bevacizumab for Retinal and Choroidal Vascular Disease

Abstract

 

Purpose:

 

To systematically study potential adverse events associatedwith the use of intraocular bevacizumab at a single medicalcenter.

 

Methods:

 

Retrospective study of all consecutive patients receiving intraocularbevacizumab injections at the Stanford University Departmentof Ophthalmology between November 15, 2005 and July 14, 2006.Bevacizumab was given for exudative age-related macular degeneration(AMD), retinal vascular occlusion, diabetic macular edema (DME),neovascular glaucoma (NVG), myopic choroidal neovascularization(CNV), von Hippel-Lindau (vHL) disease, and CNV that was idiopathic,trauma-induced, or vasculitis-related.

 

Results:

 

We analyzed medical records of 188 subjects (205 eyes) who receiveda total of 578 injections of 1.25 mg bevacizumab. Follow-uprate was 97%. The average follow-up was approximately 6 months.5 eyes with exudative AMD developed retinal pigment epithelial(RPE) tears, all with pre-existing RPE detachments (RPED’s).These 5 eyes represented 3% of all eyes treated and 7% of theeyes with pre-existing RPED’s at initiation of treatment.No subject experienced thromboembolic complications or death.Other adverse events were rare. Eyes treated for AMD gainedabout 1 line Snellen of visual acuity (p < 0.05).

 

Conclusions:

 

Intraocular bevacizumab appears to be well-tolerated for thetreatment of a variety of retinal and choroidal vascular diseases.RPE tears may occur when treating choroidal neovascularization,particularly in patients with pre-existing RPE detachment.  

 

 

Keywords: age-related macular degeneration • neovascularization • vascular endothelial growth factor