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Anales de la Sociedad Mexicana de Oftalmología y Archivos de la Asociación Para Evitar la Ceguera en México

2007, Number 1

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Rev Mex Oftalmol 2007; 81 (1)

Seguridad y eficacia de bevacizumab intravítreo como tratamiento en neovascularización coroidea subfoveal idiopática

Martínez-Castellanos MA, Ustariz-González O, Guerrero-Naranjo JL, Fromow-Guerra J, Quiroz-Mercado H

Language: Spanish
References: 27
Page: 14-20
PDF size: 673.00 Kb.


ABSTRACT

Objective: Vascular endothelial growth factor (VEGF) has been implicated as a key mediator in choroidal neovascularization (CNV). The purpose of this study was to examine the impact of anti-VEGF therapy in idiopathic choroidal neovascularization (ICNV).
Methods: Prospective, non comparative, interventional case series. 2.5 mg of bevacizumab (Avastin®, Genentech, San Francisco California), a monoclonal recombinant antibody that joins and inhibits the activity of VEGF-A, was injected intravitreal in 12 eyes with idiopathic subfoveal CNV. Clinical appearance, best corrected visual acuity (BCVA) -ETDRS-, optical coherence tomography (OCT), fluorescein angiography (FA), multifocal electroretinogram (mfERG) and systemic blood pressure were recorded and followed for 12 weeks
Results: Mean age was 37.6 years± 11.1, 7 female and 4 male. The mean visual gain was 5 lines. The macular thickness diminished in a mean of 200 µm. Reinjection was not necessary. There were no serious ocular or systemic adverse events.
Conclusions: The use of anti-VEGF agent (bevacizumab) is safe and a potential pharmacologic agent in the treatment of ICNV. Further studies should be done to rule the intervals of injections, use in combination with other therapies long term follow up and comparative studies.


REFERENCES

  1. Cohen SY, Laroche A y cols. Etiology of choroidal neovascularization in young patients. Ophthalmology 1996; 103:1241-4.

  2. Ho AC, Yannuzzi LA. The natural history of idiopathic subfoveal choroidal neovascularization. Ophthalmology 1995; 102:782-9.

  3. Lindblom B, Anderson T. The prognosis of idiopathic choroidal neovascularization in persons younger than 50 years of age. Ophthalmology 1998; 105:1816-20.

  4. Fukuchi T, Takahashi K, Ida H y cols. Staging of idiopathic choroidal neovascularization by optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2001; 239:424-9.

  5. Macular Photocoagulation Study Group. Argon laser photocoagulation for idiopathic neovascularization. Results of a randomized clinical trial. Arch Ophthalmol 1983; 101:1358-61.

  6. Macular Photocoagulation Study Group. Krypton laser photocoagulation for idiopathic neovascular lesions. Results of a randomized clinical trial. Arch Ophthalmol 1990; 108:832-7.

  7. Macular Photocogulation Study Group. Laser photocoagulation of subfoveal neovascular lesions of age-related macular degeneration. Updted findings from two clinical trials. Arch Ophthalmol 1993; 111:1200-9.

  8. Thomas MA, Grand MG, Williams DF y cols. Surgical management of subfoveal choroidal neovascularization. Ophthalmology 1992; 99:952-68.

  9. Berger AS, Kaplan HJ. Clinical experience with the surgical removal of subfoveal neovascular membranes: short-term postoperative results. Ophthalmology, 1992; 99:969-75.

  10. Thomas MA, Dickinson JD, Melberg NS y cols. Visual results after surgical removal of subfoveal choroidal neovascular membranes. Ophthalmology 1994; 101:1384-96.

  11. Lit ES, Kim RY, Damico DJ. Surgical removal of subfoveal choroidal neovascularization without removal of posterior hyaloid: a onsecutive series of young patients. Retina 2001; 21:317-23.

  12. Fuiji GY, Humayun MS, Pieramici DJ y cols. Initial experience of inferior limited macular traslocation for subfoveal choroidal neovascularization resulting from causes other than age-related macular degeneration. Am J Ophthalmol 2001; 131:541-60.

  13. Treatment of age-related macular degeneration with Photodynamic (TAP) Study Group. Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one- year results of 2 randomized clinical trials-TAP report. Arch Ophthalmol 1999.

  14. Kvanta A. Algvere PV, Berglin L, Seregard S. Subfoveal fibrovascular membranes in AMD express vascular endothelial growth factor. Invest Ophthalmol Vis Sci 1996; 37:1929-1934.

  15. Yi X, Ogata N, Komada M y cols. Vascular endothelial growth factor expression in choroidal neovascularization in rats. Graefes Arch Clin Exp Ophthalmol 1997; 235:313-319.

  16. Eugene WN, Adamis A. Targeting angiogenesis, the underlying disorder in neovascular age-related macular degeneration. Can J Ophthalmol 2005; 40:352-68.

  17. Kzystolik MG, Adamis A. Prevetion of experimental choroidal neovascularization with intravitreal anti-vascular endothelial growth factor antibody fragment. Arch Ophthalmol 2002; 120:338-46.

  18. Eyetech Study Group. Preclinical and phase IA clinical evaluation of anti-VEGF pegylated aptamer (EYE001) for the treatment for exudative macular degeneration. Retina 2002; 22:143-52.

  19. Eyetech study group. Anti-vascular endothelial growth factor therapy for subfoveal choroidal neovascularization secondary to age-related macular degeneration : Phase II study results. Ophthalmology 2003; 110:979-86.

  20. Gragoudas ES, Adamis AP, Cunninham ET Jr. y cols. VEGF Inhibition Study Ocular Neovascularization Clinical Trial Group. Pegaptanib for neovascular age-related macular edema. N Eng J Med 2004; 351:2805-16.

  21. Michels S Rosenfeld PJ. Ranibizumab therapy for neovascular age-related macular degeneration. Retin Physician 2004; 1:16-22.

  22. FDA Approves First Angiogenesis Inhibitor to Treat Colorectal Cancer. For immediate release P04-23. February 26, 2004.

  23. Evolving Guidelines for Intravitreous Injections. Retina 2004: 24 (5).

  24. Guerrero-Naranjo J, Bueno-Garcia R, Quiroz-Mercado H y cols. Security and side effects of intravitreal avastin using two methods of storage. ARVO 2006.

  25. Spaide RF, Martin ML, Slakter J, Yannuzzi LA, Sorenson J, Guyer DR, Freund KB. Treatment of idiopathic subfoveal choroidal neovascular lesions using photodynamic therapy with verteporfin. Am J Ophthalmol 2002; 134(1):62-8.

  26. Chan Wai-Man y cols. Photodynamic therapy with verteporfin for subfoveal idiopathic choroidal neovascularization. One year results from a prospective case series. Ophthalmology 2003; 110:12.

  27. Thimothy YY y cols. Transient reduction in retinal function reveled by multifocal electroretinogram after photodynamic therapy. Am J Ophthalmol 2004; 137(5):826-33.




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