title: Intravitreal bevacizumab (Avastin) in proliferative diabetic retinopathy.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of intravitreal bevacizumab in proliferative diabetic retinopathy (PDR) patients.
  
  
  METHODS
  This interventional case series study included 15 eyes of 10 patients with bilateral PDR: 13 eyes with severe PDR and active new vessels (NV) and two eyes with recurrent vitreous haemorrhages. Study eyes received a single intravitreal injection of 1.25 mg (0.05 ml) bevacizumab. All eyes were followed up for 3 months, and eight of them for 9 months. Reinjection was performed in three eyes 4-6 months after the first injection. Study eyes were evaluated by fluorescein angiography at baseline, 1, 3 and 9 months. Quantitative planimetric analysis (QPA) of NV area was measured before and after treatment. All eyes received or completed panretinal photocoagulation (PRP) 1 month after the first injection.
  
  
  RESULTS
  As early as at 1 month, all study eyes had a regression (paired t-test, P = 0.01) of QPA-estimated NV area. The eyes with recurrent vitreous haemorrhages had clearing of bleeding. These early effects were maintained at 3 months for all eyes and tended to be stable at 9 months. The fast and measurable efficacy of bevacizumab allowed a subsequent complete and safe PRP.
  
  
  CONCLUSIONS
  Intravitreal bevacizumab did not reveal any side-effects and was effective in the regression of NV areas and the resolution of vitreous haemorrhages. This approach is potentially useful in allowing (within a planned temporal window) a safe and efficient PRP to be performed while minimizing the risk of its complications.
authors.affiliation: Department of Ophthalmology, Catholic University of Sacred Hearth, Rome, Italy. aminnella@fastwebnet.it
authors.forename: Angelo M
authors.initials: AM
authors.lastname: Minnella
authors.forename: Cristina M
authors.initials: CM
authors.lastname: Savastano
authors.forename: Lucia
authors.initials: L
authors.lastname: Ziccardi
authors.forename: Andrea
authors.initials: A
authors.lastname: Scupola
authors.forename: Benedetto
authors.initials: B
authors.lastname: Falsini
authors.forename: Emilio
authors.initials: E
authors.lastname: Balestrazzi
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D015861:Retinal Neovascularization / Q000175:diagnosis / Q000188:drug therapy*; D019233:Retreatment; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014822:Vitreous Body; D014823:Vitreous Hemorrhage / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab