Vascular events in patients with age-related macular degeneration treated with intraocular bevacizumab.
OBJECTIVE
The purpose of this study was to determine the incidence of vascular events in patients treated with intraocular injections of bevacizumab.


METHODS
The subjects were 769 persons (mean age, 79.9 years; range, 47-97 years) from the Barnes Retina Institute in St. Louis. Patients received at least one intraocular injection of bevacizumab for the treatment of neovascular age-related macular degeneration. The study endpoints included myocardial infarction, cerebrovascular accident, thromboembolic disease, new hypertension, bleeding, and death.


RESULTS
There were events in 74 patients (9.6%; 95% confidence interval, 7.5-11.7%) over a mean follow-up of 13.2 months (range, 1-23 months). Among other events, 15 patients (2.0%; 95% confidence interval, 1-3%) had a nonlethal myocardial infarction, 27 patients (3.5%; 95% confidence interval, 2.2-4.8%) had an episode of new or increased blood pressure, and 19 patients (2.5%; 95% confidence interval, 1.4-3.6%) died. There was no correlation between the number of bevacizumab injections and incidence of any event.


CONCLUSIONS
Intraocular bevacizumab may be safe for intraocular use from a systemic standpoint.
Sheybani
Arsham
A
Department of Internal Medicine, St John's Mercy Health Care, School of Medicine, Washington University in St Louis, St Louis, MO 63110, USA.
Kymes
Steven
S
Schlief
Shelley
S
Apte
Rajendra
R
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007267:Injections; D008268:Macular Degeneration / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced; D012307:Risk Factors; D013923:Thromboembolism / Q000139:chemically induced; D014652:Vascular Diseases / Q000139:chemically induced*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab