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M. Luke, K. Januschowski, J. Beutel, K. U. Bartz-Schmidt, P. Szurman, Tuebingen Bevacizumab Study Group; The Retinal Tolerance to Bevacizumab in Co-Application With a Recombinant Tissue Plasminogen Activator. Invest. Ophthalmol. Vis. Sci. 2007;48(13):77.
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To investigate the retinal toxicity of bevacizumab in co-application with rt-PA, a commercially available recombinant tissue plasminogen activator (rt-PA), and to facilitate a new therapeutic concept in the treatment of massive subretinal haemorrhage caused by neovascular age-related macular degeneration (AMD).
Isolated bovine retinas were perfused with an oxygen preincubated nutrient solution. The electroretinogram (ERG) was recorded as a transretinal potential using Ag/AgCl electrodes. Bevacizumab (0.25mg/ml) and rt-PA (20µg/ml) was added to the nutrient solution for 45 min. Thereafter, the retina was reperfused for 60 min with normal nutrient solution. Similarly, the effects of rt-PA (20µg/ml and 60µg/ml) were investigated on the a- and b-wave amplitude. The percentage of a- and b-wave reduction during the application and at the washout was calculated.
During the application of different concentrations of rt-PA (20µg/ml and 60µg/ml) as well as for the co-application with bevacizumab (0.25mg/ml, 20µg/ml rt-PA) no significant reduction of the a- and b-wave amplitude was observed. During the washout, the ERG-amplitudes remained unchanged.
The present study suggests that a subretinal injection of 20µg/ml rt-PA in co-application with bevacizumab (0.25mg/ml) for the treatment of massive subretinal haemorrhage seems possible.
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