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E. L. Thomas; Microdose Intravenous Bevacizumab for the Treatment of Retinal Vascular Diseases Mediated by Vascular Endothelial Growth Factor (VEGF). Invest. Ophthalmol. Vis. Sci. 2008;49(13):3460.
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To demonstrate microdose (1.25-2.5mg) bevacizumab given intravenously has a bilateral salutary effect avoiding the need for intraocular injections or high dose systemic injections. Intravitreous bevacizumab in doses of 1.25 to 2.5 mg can produce a salutary effect on both eyes of patients with bilateral disease.
A retrospective chart review of thirty seven patients with either bilateral retinal vascular disease including macular degeneration, diabetic retinopathy and vein occlusions or who refused intraocular injection were treated microdose bevacizumab intravenously and followed by optical coherence tomography and fluorescein angiography to determine efficacy.
Eleven patients had a complete response with resolution of cystic retinal changes in diabetic maculopathy and vein occlusions and neovascularization of the iris in patients with rubeosis. In age related macular degeneration, resolution of intraretinal fluid, subretinal fluid and sub-retinal pigment epithelial fluid was noted. Eleven eyes had a partial response with reduction but not resolution of these parameters and the remainder of eyes had no response at this low dose.
Selected patients with bilateral disease or who refused intraocular injection may benefit from microdose bevacizumab given intravenously. Larger doses, though much smaller than the systemic dose of 400 mg given for cancer treatment, may be necessary in recalcitrant cases.
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