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Study questions systemic bioavailability of intravitreal anti-VEGF
Retina. 2009;29(1):20-26.
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A lack of change in visual acuity, central thickness and other measures in fellow, untreated eyes of patients administered bevacizumab for diffuse bilateral diabetic macular edema may mean a lack of biodistribution of the drug.
However, the small sample size of patients in the pilot study prevented researchers from reaching definitive conclusions. In previous studies in humans, researchers have shown that intravenous Avastin (bevacizumab, Genentech) has a demonstrable effect on age-related macular degeneration, and animal studies have suggested that intravitreal bevacizumab enters the bloodstream and fellow eye.
In theory, if intravitreal bevacizumab were to enter the bloodstream, patients treated for retinal pathologies with the antibody might be at risk for adverse effects that have been associated with use of systemic bevacizumab in treating cancers.
But, measures of visual acuity, central retinal thickness and macular volume in the fellow, untreated eye of 23 consecutive patients receiving a single 2.5-mg dose of bevacizumab did not change significantly from baseline at either 2 or 4 weeks after injection, indicating “that the effect on the contralateral eye of bevacizumab is unlikely,” according to the study.