Repeat injections of bevacizumab are well tolerated

Repeat intravitreal injections of bevacizumab (off-label Avastin) for diseases such as proliferative diabetic retinopathy (DR), diabetic macular oedema (DME), retinal vein occlusions and choroidal neovascularization (CNV) appear to be safe and well tolerated, according to a report published in the August issue of Graefes Archive for Clinical and Experimental Ophthalmology.

Maria Ana Martínez-Castellanos and colleagues from the Pan American Collaborative Retina Group (PACORES), based at the Instituto de Cirugía Ocular, San José, Costa Rica injected 1,265 consecutive patients with bevacizumab between 1 September 2005 and 31 January 2006. The subjects were treated for various disease such as proliferative DR, DME, retinal vein occlusion and CNV of several aetiologies including age-related macular degeneration (AMD). Of these, 92 were excluded because they were lost to follow-up. Patients were examined at baseline and then monthly for a 12-month period.

A total of 4,303 injections were administered and all patients were followed-up for the whole 12-month period. Systemic adverse events were reported in 18 (1.5%) patients and these included seven (0.59%) cases of acute elevation of systemic blood pressure, six (0.5%) cerebrovascular accidents, five (0.4%) myocardial infarctions, two (0.17%) iliac artery aneurysms, two (0.17%) toe amputations and five (0.4%) deaths. Ocular complications included seven (0.16%) cases of bacterial endophthalmitis, seven (0.16%) tractional retinal detachments, four (0.09%) cases of uveitis and one (0.02%) case of rhegmatogenous retinal detachment and vitreous haemorrhage.

The PACORES groups concluded that, although longer follow-up is required, bevacizumab is generally safe and well tolerated during the first year of therapy.