Intravitreal bevacizumab: an analysis of the evidence

Figures & data

Table 1 Effect of a single intravitreal injection of 2.5 mg bevacizumab on median BCVA and CRT at 0 and 4 weeks in patients with neovascular ARMD

Authors	n =	Median logMAR BCVA at 0 wks	Median logMAR BCVA at 4 wks	Median CRT in μm at 0 wks	Median CRT in μm at 4 wks
Bashshur et al 2006	17	1.0	0.6 (p = 0.001)	350	282 (p < 0.001)
Abrahám-Marin et al 2006	39	1.18	0.88 (p = 0.002)	388	247 (p < 0.001)

Abbreviations: ARMD, age-related macular degeneration; BCVA, best corrected visual acuity; CRT, central retinal thickness.

Table 2 Effect of mostly single intravitreal injections of 1.25 mg bevacizumab on mean logMAR BCVA and mean CRT (μm) in neovascular ARMD

Authors	n =	Baseline CRT	Baseline BCVA	↓CRT 4 wks	BCVA 4 wks	↓CRT 12 wks	BCVA 12 wks	↓CRT >12 wks	BCVA >12 wks
Moschos et al 2007	18	298.5	0.62	52.72 (p < 0.001)	0.57 (p < 0.05)	43.5 (p = 0.0592)	0.60 (p = 0.2261)	–	–
Aggio et al 2006	17	404.05	1.17	–	–	–	–	123.82 (p = 0.032)	1.06 (p = 0.17)

Abbreviations: ARMD, age-related macular degeneration; BCVA, best corrected visual acuity; CRT, central retinal thickness.

Figure 1 Effect of repeated intravitreal injections of 1.25 mg bevacizumab on mean logMAR best corrected visual acuity (BCVA).

Table 3 Effect of repeated intravitreal injection of 1.25 mg bevacizumab on mean logMAR BCVA in patients with neovascular ARMD

Authors	n =	Previous Rx (%)	Baseline	4–6 wks	8–10 wks	12–14 wks	>14 wks
Avery et al 2006	81	63 (78)	1.00	0.80 (p < 0.0001)	0.80 (p < 0.0001)	–	–
Yoganathan et al 2006	50	36 (72)	0.96	0.83 (p < 0.01)	0.73	0.80	0.86 (P < 0.01)
Rich et al 2006	53	40 (75)	0.94	0.82 (p < 0.001)	0.76 (p = 0.001)	0.78 (p < 0.001)	–
Spaide et al 2006	251	175 (69)	0.96	0.84 (p < 0.001)	0.79 (p < 0.001)	0.74 (p < 0.001)	–
Lazic et al 2007	102	0 (0)	1.07	–	–	–	0.94 (P = 0.001)
Aisenbrey et al 2006	30	4 (13)	0.78	0.59	–	0.63 (p < 0.001)	–
Chen et al 2007	102	56 (55)	0.60	0.50 (p < 0.001)	0.40 (p < 0.001)	0.40 (p < 0.05)	–
Giansanti et al 2007	27	14 (52)	0.72	0.74	0.80	0.68 (P = 0.40)	0.86
Emerson et al 2007	79	47 (59)	0.71	0.58 (p = 0.00037)	–	0.63 (p = 0.04)	–
Goff et al 2007	54	38 (70)	0.80	–	–	–	0.7 (p = 0.03)
Weighted mean	829		0.88 (n = 829)	0.74 (n = 673)	0.71 (n = 564)	0.67 (n = 592)	0.86 (n = 233)

Abbreviations: ARMD, age-related macular degeneration; BCVA, best corrected visual acuity; CRT, central retinal thickness.

Figure 2 Decrease (Δ) in central retinal thickness (CRT) (μm) after repeated 1.25 mg bevacizumab injections in patients with neovascular age-related macular degeneration.

Table 4 Decrease (Δ) in mean CRT (μm) after repeated intravitreal injections of 1.25 mg bevacizumab in patients with neovascular ARMD

Authors	n =	Previous Rx (%)	Baseline CRT	4–6 wks	8–10 wks	12–14 wks	>14 wks
Avery et al 2006	81	63 (78)	–	92 (p < 0.0001)	89 (P < 0.0001)	67 (P < 0.01)	–
Yoganathan et al 2006	50	36 (72)	339	70 (p < 0.001)	99	63	73 (p < 0.001)
Rich et al 2006	53	40 (75)	351	97.5 (p < 0.001)	110.8 (P < 0.001)	99.6 (P < 0.001)	–
Spaide et al 2006	251	175 (69)	340	93 (p < 0.001)	–	127 (P < 0.001)	–
Lazic et al 2007	102	0 (0)	378	–	–	–	56 (p = 0.01)
Aisenbrey et al 2006	30	4 (13)	–	–	–	–	–
Chen et al 2007	102	56 (55)	251	36.1 (p < 0.001)	46.2 (P < 0.001)	41 (P < 0.05)	–
Giansanti et al 2007	27	14 (52)	373	–	–	94 (P < 0.01)	70 (p < 0.01)
Emerson et al 2007	79	47 (59)	304	77 (p < 0.00001)	–	67 (P = 0.00002)	–
Goff et al 2007	54	38 (70)	362	127 (p < 0.0001)	–	124 (P = 0.0004)	118 (P < 0.0001)
Weighted mean	829			83.71 (n = 670)	79.52 (n = 286)	92.46 (n = 697)	75.64 (n = 233)

Abbreviations: ARMD, age-related macular degeneration; CRT, central retinal thickness.

Table 5 Effect of intravitreal bevacizumab on BCVA in patients with diabetic retinopathy

Authors	n =	Dose	Mean follow-up	Mean logMAR BCVA at 0 wks	Mean logMAR BCVA at end of study
Avery et al 2006	45	6.2 μg–1.25 mg	5 wks	1.00	0.796
Jorge et al 2006	15	1.5 mg	12 wks	0.90	0.77
Arevalo et al 2005	78	1.25 mg or 2.5 mg	6.31 ± 0.81 months	0.87	0.6
Weighted mean	138			0.92	0.68

Abbreviations: BCVA, best corrected visual acuity.

Table 6 Effect of intravitreal injection of bevacizumab on BCVA in RVO patients receiving a dose of 1.25 mg

Authors	Type of RVO	N =	Baseline	4 wks	12 wks
Iturralde et al 2006	CRVO	16	1.48	1.05 (p = 0.001)	0.84 (p < 0.001)
Pai et al 2007	9 CRVO and 12 BRVO	21	1.28	0.83 (p = 0.001)	0.95 (p = 0.001)
Rabena et al 2007	BRVO	27	1.0	0.69	0.70
Weighted mean		64	1.21	0.83	0.82

Abbreviations: BCVA, best corrected visual acuity; RVO, retinal vein occlusion.

Table 7 Effect of intravitreal injection of bevacizumab on CRT (μm) in RVO patients receiving a dose of 1.25 mg

Authors	Type of RVO	N =	Baseline	4 wks	12 wks
Iturralde et al 2006	CRVO	16	887	372 (p < 0.001)	–
Pai et al	9 CRVO and 12 BRVO	21	647.81	293.43 (p = 0.001)	320.90 (p = 0.001)
Rabena et al 2007	BRVO	27	478	310	366
Weighted mean			635.97 (n = 64)	320.06 (n = 64)	346.27 (n = 48)

Abbreviations: CRT, central retinal thickness; RVO, retinal vein occlusion.

Figure 3 Effect of 1.25 mg intravitreal bevacizumab injection on mean logMAR best corrected visual acuity (BCVA) in retinal vein occlusion patients (n = 64).

Figure 4 Effect of 1.25 mg intravitreal bevacizumab injection on mean central retinal thickness CRT (μm) in retinal vein occlusion patients.

Table 8 Other reported uses of intravitreal bevacizumab

CNV related to angioid streaks Peripapillary CNV Idiopathic juxtafoveal retinal telangiectasis (Moon et al 2007) Sickle cell retinopathy Pseudophakic cystoid macular edema Anterior segment ischemia Chronic uveitic macular edema (no significant improvement) Idiopathic CNV CNV secondary to central serous chorioretinopathy CNV secondary to punctate inner choriodopathy Retinal angiomatous proliferation Radiation maculopathy (Ziemssen et al 2007) Cystoid macular edema in retinitis pigmentosa (Melo et al 2007) Radiation optic neuropathy (Finger 2007) Eales disease (Kumar and Sinha 2007) Adjunct to filtering surgery (Jonas et al 2007)

Abbreviation: CNV, choroidal neovascularization.

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