Intravitreal bevacizumab for diabetic retinopathy

Curr Diabetes Rev. 2009 Feb;5(1):39-46. doi: 10.2174/157339909787314121.

Abstract

Diabetic retinopathy (DR) remains the major threat to sight in the working age population. Diabetic macular edema (DME) is a manifestation of DR that produces loss of central vision. Macular edema within 1 disk diameter of the fovea is present in 9% of the diabetic population. Proliferative diabetic retinopathy (PDR) is a major cause of visual loss in diabetic patients. In PDR, the growth of new vessels from the retina or optic nerve, is thought to occur as a result of vascular endothelial growth factor (VEGF) release into the vitreous cavity as a response to ischemia. Furthermore, VEGF increases vessel permeability leading to deposition of proteins in the interstitium that facilitate the process of angiogenesis and macular edema. This review demonstrates multiple benefits of intravitreal bevacizumab on DR including DME and PDR. The results indicate that intravitreal bevacizumab injections may have a beneficial effect on macular thickness and visual acuity (VA), independent of the type of macular edema that is present. Therefore, in the future this new treatment modality could replace or complement focal/grid laser photocoagulation in DME. In addition, in PDR, this new option could be an adjuvant agent to PRP so that more selective therapy may be applied.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Diabetic Retinopathy / drug therapy*
  • Diabetic Retinopathy / pathology
  • Humans
  • Macular Edema / drug therapy*
  • Macular Edema / pathology
  • Neovascularization, Pathologic / prevention & control*
  • Optic Nerve / drug effects
  • Optic Nerve / pathology
  • Recurrence
  • Retinal Vessels / drug effects
  • Retinal Vessels / pathology
  • Vascular Endothelial Growth Factor A / physiology
  • Vitreous Body / blood supply
  • Vitreous Body / drug effects*
  • Vitreous Body / physiopathology

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Vascular Endothelial Growth Factor A
  • Bevacizumab