Intravitreal bevacizumab: an analysis of the evidence

Derrick P Smit, David Meyer

Division of Ophthalmology, Faculty of Health Sciences, University of Stellenbosch, Western Cape, South Africa

Purpose: To review the English language publications addressing the effect of intravitreal bevacizumab (IVB) injection in a variety of eye conditions and analyze the data where possible.

Methods: Examination of data obtained using a Pubmed literature search conducted mid May 2007 with the keywords “intravitreal bevacizumab”.

Results: A dose of 1.25 mg was used in 89.5% of 965 age-related macular degeneration (ARMD) cases with 47% receiving intravitreal bevacizumab as primary therapy. In 829 patients receiving repeated doses of 1.25 mg the mean logMAR best-corrected visual acuity (BCVA) improved from 0.88 at baseline to 0.74 at 4–6 weeks, 0.71 at 8–10 weeks, 0.67 at 12–14 weeks and 0.86 at >14 weeks. Mean central retinal thickness (CRT) decreased by 83.71 µm at 4–6 weeks, 79.52 µm at 8–10 weeks, 92.46 µm at 12–14 weeks, and 75.64 µm at >14 weeks respectively. In 64 patients receiving IVB for retinal vein occlusion (RVO) mean logMAR BCVA decreased from 1.21 at baseline to 0.83 and 0.82 at 4 and 12 weeks respectively. Mean CRT decreased from 635.97 µm at baseline to 320.06 µm and 346.27 µm at 4 and 12 weeks. Favorable responses have been reported in various other conditions.

Conclusions: Current evidence suggests that intravitreal bevacizumab, alone or as an adjunct to conventional therapy, has a beneficial effect in various neovascular and edematous retinal conditions and is well tolerated in the short term.

Keywords: intravitreal, bevacizumab, review