Clinical Studies of Intravitreal Injection of Bevacizumab (Avastin®) for Rubeosis Associated With Proliferative Diabetic Retinopathy

Abstract

Purpose: : To evaluate the efficacy and short–term safety of intravitreal injection of bevacizumab (Avastin® ) in patients with rubeosis associated with proliferative diabetic retinopathy.

Design: : Off–label, single–center, uncontrolled clinical study.

Methods: : Intravitreal injection of bevacizumab (1mg) was conducted in a consecutive series of 3 eyes with rubeosis iridis associated with proliferative diabetic retinopathy which poorly responded to laser photocoagulation and vitrectomy. Pre–injection parameters (visual acuity / intraocular pressure [mmHg]) in the 3 eyes were 0.3/30, 0.1/32, and 0.2/14, respectively. Ophthalmic examination, including visual acuity and intraocular pressure measurements, were conducted 1 day, 1 week, and 1 month after injection. Regression of rubeosis was evaluated based on slit–lamp examination with gonioscopy and fluorescein angiography.

Results: : Rubeosis iridis had regressed in 2 eyes (67%) and disappeared completely in 1 eye (33%) from 1 week following injection. Visual acuity remained stable without recurrence of rubeosis and the intraocular pressure was also unchanged for at least 1 month. No inflammation and endophtahlmitis were observed.

Conclusions: : Intravitreal injection of bevacizumab may provide an effective and safe alternative for patients with diabetic rubeosis refractory to conventional treatments.

Keywords: diabetic retinopathy • neovascularization • drug toxicity/drug effects