Postoperative use of bevacizumab as an antifibrotic agent in glaucoma filtration surgery in the rabbit.
OBJECTIVE
To evaluate the efficacy of bevacizumab as an antifibrotic agent after trabeculectomy in rabbits.


METHODS
Forty-two rabbits underwent trabeculectomy and were randomly assigned to receive a postoperative course of seven subconjunctival injections of bevacizumab (1.25 mg, 25 mg/mL), 5-fluorouracil (5-FU; 5 mg, 50 mg/mL), or balanced salt solution (BSS; 0.1 mL, control). Bleb survival and characteristics were evaluated over a 30-day period. The animals were killed on postoperative day (PD)10, PD20, and PD30. Histology and immunohistochemistry of the surgical eyes was performed to evaluate and grade the amount of scarring and fibrosis in each group.


RESULTS
Bevacizumab significantly improved the outcome of filtration surgery in this model. Bevacizumab prolonged bleb survival compared with the 5-FU and control groups (16.0 +/- 1.3 days vs. 6.9 +/- 0.6 and 7.4 +/- 0.85 days, respectively; P < 0.001). Bevacizumab-treated eyes had significantly larger and higher blebs than the control and 5-FU-treated groups (P < 0.05). Histologic analysis revealed that eyes treated with bevacizumab had significantly less postoperative scarring at the microscopic level at PD10 and PD20 (P = 0.009).


CONCLUSIONS
Postoperative subconjunctival injection of bevacizumab is associated with improved trabeculectomy bleb survival in the rabbit model. Bevacizumab may be a useful agent for improving success and limiting scar tissue formation after trabeculectomy.
Memarzadeh
Farnaz
F
Doheny Eye Institute, Los Angeles, California 90033, USA.
Varma
Rohit
R
Lin
Le-Tien
LT
Parikh
Jignesh G
JG
Dustin
Laurie
L
Alcaraz
Ana
A
Eliott
Dean
D
D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000068258:Bevacizumab; D003228:Conjunctiva / Q000473:pathology; D004195:Disease Models, Animal; D005347:Fibroblasts / Q000187:drug effects; D005355:Fibrosis / Q000517:prevention & control; D005472:Fluorouracil / Q000627:therapeutic use; D005901:Glaucoma / Q000473:pathology / Q000601:surgery*; D007267:Injections; D007429:Intraocular Pressure; D011182:Postoperative Care; D011379:Prognosis; D011817:Rabbits; D012590:Sclera / Q000473:pathology; D014130:Trabeculectomy; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014945:Wound Healing / Q000187:drug effects
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000964:Antimetabolites, Antineoplastic; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D005472:Fluorouracil