You have full text access to this OnlineOpen article

Ultrasound assessment of short-term ocular vascular effects of intravitreal injection of bevacizumab (Avastin®) in neovascular age-related macular degeneration

  1. Philippe Bonnin1,2,
  2. Jean-Antoine C. Pournaras3,
  3. Zineb Lazrak3,
  4. Salomon Yves Cohen3,
  5. Jean-François Legargasson1,4,
  6. Alain Gaudric3,5,
  7. Bernard I. Levy1,5,
  8. Pascale Massin3,5

Article first published online: 26 JUN 2009

DOI: 10.1111/j.1755-3768.2009.01526.x

Issue

Acta Ophthalmologica

Acta Ophthalmologica

Volume 88, Issue 6, pages 641–645, September 2010

Additional Information

How to Cite

Bonnin, P., Pournaras, J.-A. C., Lazrak, Z., Cohen, S. Y., Legargasson, J.-F., Gaudric, A., Levy, B. I. and Massin, P. (2010), Ultrasound assessment of short-term ocular vascular effects of intravitreal injection of bevacizumab (Avastin®) in neovascular age-related macular degeneration. Acta Ophthalmologica, 88: 641–645. doi: 10.1111/j.1755-3768.2009.01526.x

Author Information

  1. 1

    AP-HP, Physiology – Functional Investigations, Lariboisière Hospital, University of Paris, Paris, France

  2. 2

    INSERM U965, Angiogenesis and Translation Research, Lariboisière Hospital, Paris, France

  3. 3

    AP-HP, Ophthalmology, Lariboisière Hospital, University of Paris, Paris, France

  4. 4

    Laboratory for the Cellular and Molecular Pathophysiology of the Retina, INSERM UMR 592, Paris, France

  5. 5

    Cardiovascular Research Centre, INSERM Lariboisière U689, Paris, France

*Dr Philippe Bonnin Physiologie, Explorations Fonctionnelles Hôpital Lariboisière Université Paris 7 2 rue Ambroise-Paré 75475 Paris CEDEX 10 France Tel: + 33 1 49 95 80 95 Fax: + 33 1 49 95 88 71 Email: philippe.bonnin@lrb.aphp.fr

Publication History

  1. Issue published online: 27 AUG 2010
  2. Article first published online: 26 JUN 2009
  3. Received on June 24th, 2008. Accepted on December 2nd, 2008.

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (277K)

Keywords:

  • antiangiogenic therapy;
  • age-related macular degeneration (AMD);
  • central retinal artery;
  • ciliary artery;
  • ophthalmic artery;
  • ultrasound imaging

Acta Ophthalmol. 2010: 88: 641–645

Abstract.

Purpose:  Angiogenic inhibitors, alone or combined with other therapies, are believed to represent a promising treatment for neovascularization in age-related macular degeneration (wet AMD). They can maintain or improve visual acuity (VA), at least for the first 2 years. However, evolution to retinal atrophy cannot be ruled out and it may be useful to assess the effects of antiangiogenic therapy on retinal and choroidal circulation.

Methods:  We carried out a pilot study in 15 patients with wet AMD. Time-averaged mean blood flow velocities (BFVs) in the central retinal, temporal posterior ciliary and ophthalmic arteries (CRA, TPCA and OA) were measured by ultrasound imaging before and 4 weeks after a single intravitreal injection of 1.25 mg bevacizumab in 0.05 ml. Patients underwent two ophthalmic examinations, before and 4 weeks after injection, including VA measurement and optical coherence tomography (OCT3) examination.

Results:  In treated eyes, bevacizumab injection was followed by a significant improvement in VA (from 20/125 to 20/80; p = 0.0214), and a decrease in mean central macular thickness (from 392 ± 96 μm to 271 ± 50 μm; p = 0.0038). Mean BFV decreased by 10% in the CRA (p = 0.0226), 20% in the TPCA (p = 0.0026) and 20% in the OA (p = 0.0003). No effect was observed in fellow eyes.

Conclusions:  Intravitreal bevacizumab acutely improved VA and reduced central macular thickness in wet AMD. Ultrasound imaging revealed that BFVs decreased in all retrobulbar arteries, suggesting that after local diffusion, bevacizumab exerts a short-term regional effect. Bevacizumab might therefore induce hypoperfusion of the whole eye, which may correspond to a vascular side-effect.

View Full Article (HTML) Get PDF (277K)