‘Rapid regression’ of proliferative diabetic retinopathy seen after Avastin injection

RIO GRANDE, Puerto Rico — In patients with proliferative diabetic retinopathy, an intravitreal injection of bevacizumab “induced a rapid regression of retinal and iris neovascularization,” said Robert L. Avery, MD, here at the Masters of the American Society of Retina Specialists meeting.

Dr. Avery used intravitreal Avastin (bevacizumab, Genentech) on 45 eyes of 32 patients with proliferative diabetic retinopathy. The average patient age was 58 years.

“We used lower and lower doses [of Avastin] and still saw a dramatic result,” he said.

If the patient needs surgery, Dr. Avery recommended surgeons inject Avastin before vitrectomy surgery to reduce potential leakage, and he said surgeons should proceed with caution. The drug may penetrate the fovea, and the level of penetration may be dose-related. He recommended injecting between 3 and 10 days preoperatively.

“These are very short-term results,” he said. “The lower dose may be effective, but longer-term follow-up is still needed.” Early results indicate intravitreal dosing has been successful, and in some cases one injection was sufficient to eliminate rubeosis.

“Patients with diabetic macular edema do not respond as well,” he cautioned. For those patients, he recommended using intravitreal triamcinolone.