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.2^–10

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.11^–14

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 …