Abstract
Purpose: :
To evaluate the effect of multiple intravitreal injections of bevacizumab on blood - aqueous barrier permeability.
Methods: :
Forty-eight consecutive patients (49 eyes) with neovascular age-related macular degeneration were examined before, 1 day, 1 week and 1 month after each intravitreal administration of 1.25 mg of bevacizumab. Number of injections in each patient ranged from 2 to 5 (mean - 3.1 injections). Mean follow-up period was 7 months (from 1 to 14 months). The injections were performed under sterile conditions. The anterior chamber inflammatory activity was evaluated using biomicroscopy and the laser flare meter (Kowa FM-500, Kowa Company, Ltd., Tokyo, Japan).
Results: :
None of the 48 consecutive patients had significant, clinically detecteble inflammatory response within the observation period. Anterior chamber inflammatory activity measured by laser flare meter ranged from 2.5 photons per millisecond (ph/ms) to 16.8 ph/ms (median +/- SD, 6.4 +/- 2.4 ph/ms) before treatment. One day after each injection, values were between 2.9 ph/ms and 45.3 ph/ms (median +/- SD, 6.9 +/- 2.4 ph/ms). 1 week and 1 month after each injection values were between 1.8 ph/ms to 23 ph/ms (median +/- SD, 6.25 +/- 2.4 ph/ms) and 1 ph/ms and 27 ph/ms (median +/- SD, 6.4+/- 2.6 ph/ms) respectively. There was no significant change of anterior chamber flare at neither 1 day nor 1 week or 1 month compared with baseline noted. Additionally we did not observed any differences in blood-aqueous barrier permeability between 1st and 2nd, 3rd, 4th and 5th bevacizumab administration (p=0.13).
Conclusions: :
No inflammatory response was detected clinically and by laser flare meter after each intravitreal bevacizumab administration. These results suggest that monthly chronic dosing intravitreal bevacizumab treatment seems to be safe. No anterior chamber inflammatory response could be due to the known anti-inflammatory effect of anti-vascular endothelial growth factor therapy.
Clinical Trial: :
Local Research Ethics Committee - KE-02-54/52/2007
Keywords: vascular endothelial growth factor • retinal neovascularization • age-related macular degeneration