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Systemic antiangiogenic therapy: what goes around…
  1. Jose S Pulido,
  2. Sujit Itty
  1. Professor J S Pulido, 200 First St SW, Department of Ophthalmology, Mayo Clinic, Rochester, NY 55902, USA; pulido.jose{at}mayo.edu

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The concept of antiangiogenic therapy initially developed by the late Judah Folkman has revolutionised ophthalmology and oncology.1 In addition, local ocular antiangiogenesis therapy has been shown to be non-toxic and efficacious, and so both intravitreal ranibizumab and bevacizumab have revolutionised our treatment of ocular neovascular diseases.210

Concurrently, there has been a thread in the ophthalmic literature of small case series and case reports involving the systemic use of anti-vascular endothelial growth factor (VEGF) antibodies either purposefully for ocular disease or in cases where patients had a systemic cancer in combination with ocular neovascularisation or macular oedema with apparent success.1114

Initially, Rosenfeld and his coauthors used the standard dose of intravenous bevacizumab that was used for colonic carcinoma. They treated a total of 18 patients in an open-labelled trial with infusions given every other week for a total of two or three infusions. The visual acuity was followed for 24 …

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