@article {745, title = {Aflibercept therapy for exudative age-related macular degeneration resistant to bevacizumab and ranibizumab.}, journal = {Am J Ophthalmol}, volume = {156}, year = {2013}, month = {2013 Jul}, pages = {15-22.e1}, abstract = {

PURPOSE: To evaluate the outcome of intravitreal injection of aflibercept in cases with exudative age-related macular degeneration, (AMD) resistant to injections of bevacizumab or ranibizumab.

DESIGN: Retrospective observational case series.

METHODS: A retrospective chart review at a single institution was conducted to identify patients with exudative AMD and choroidal neovascularization (CNV) in 1 or both eyes resistant to treatment with ranibizumab or bevacizumab who were switched to treatment with at least 3~monthly injections of aflibercept. In total, 36 eyes from 31 patients were included. The demographic data, visual acuities, central macular thickness on optical coherence tomography (OCT), complications, and number of injections were reviewed.

RESULTS: The mean patient age was 79 years (range 60-88). There were 13 male and 18 female patients. The number of prior injections with either bevacizumab or ranibizumab ranged from 6-74. After 3~monthly injections of aflibercept, there was a reduction of either subretinal or intraretinal fluid in 18 of 36 (50.0\%) of the treated eyes; the amount of fluid remained stable in 15 eyes (41.7\%) and worsened in 3 eyes (8.3\%). A significant average decrease was observed for the central macular thickness after 3 injections of 65~μm (P~= 2.9~{\texttimes} 10(-6)), with no significant change in visual acuity.

CONCLUSIONS: Aflibercept therapy appears to be beneficial in a subset of patients with neovascular age-related macular degeneration who exhibit recurrent or resistant intraretinal or subretinal fluid following multiple injections with either bevacizumab or ranibizumab.

}, keywords = {Aged, Aged, 80 and over, Angiogenesis Inhibitors, Antibodies, Monoclonal, Humanized, Bevacizumab, Drug Resistance, Drug Substitution, Exudates and Transudates, Female, Humans, Intravitreal Injections, Male, Middle Aged, Postoperative Complications, Ranibizumab, Receptors, Vascular Endothelial Growth Factor, Recombinant Fusion Proteins, Retina, Retreatment, Retrospective Studies, Subretinal Fluid, Tomography, Optical Coherence, Treatment Outcome, Vascular Endothelial Growth Factor A, Visual Acuity, Wet Macular Degeneration}, issn = {1879-1891}, doi = {10.1016/j.ajo.2013.02.017}, author = {Bakall, Benjamin and Folk, James C and Boldt, H Culver and Sohn, Elliott H and Stone, Edwin M and Russell, Stephen R and Mahajan, Vinit B} } @article {765, title = {Intravitreal bevacizumab for peripapillary choroidal neovascular membranes.}, journal = {Arch Ophthalmol}, volume = {130}, year = {2012}, month = {2012 Aug}, pages = {1073-5}, keywords = {Adult, Aged, Aged, 80 and over, Angiogenesis Inhibitors, Antibodies, Monoclonal, Humanized, Bevacizumab, Choroidal Neovascularization, Female, Fluorescein Angiography, Humans, Intravitreal Injections, Macular Degeneration, Male, Middle Aged, Retreatment, Subretinal Fluid, Tomography, Optical Coherence, Treatment Outcome, Vascular Endothelial Growth Factor A, Visual Acuity}, issn = {1538-3601}, doi = {10.1001/archophthalmol.2012.465}, author = {Davis, Andrew S and Folk, James C and Russell, Stephen R and Sohn, Elliott H and Sohn, Elliot H and Boldt, H Culver and Stone, Edwin M and Mahajan, Vinit B} } @article {783, title = {Uveitis following intravitreal bevacizumab: a non-infectious cluster.}, journal = {Ophthalmic Surg Lasers Imaging}, volume = {42}, year = {2011}, month = {2011 Jul-Aug}, pages = {292-6}, abstract = {

BACKGROUND AND OBJECTIVE: In this retrospective case series, the authors report seven cases of bevacizumab-related uveitis that occurred within a 4-month period.

PATIENTS AND METHODS: Seven eyes of six patients developed non-infectious uveitis following bevacizumab intravitreal injections in a cohort of 978 consecutive bevacizumab injections.

RESULTS: The mean age of patients was 74.6 years (range: 26 to 92). All patients developed symptom onset within 1 day of injection. Shared signs and symptoms included corneal edema, anterior chamber and vitreous cell, conjunctival injection, ocular pain, and lack of hypopyon. In all patients, visual acuity returned to within one line of baseline acuity. All seven eyes had been previously injected with bevacizumab, with a mean number of antecedent injections of 6.1 (range: 3 to 12).

CONCLUSION: A cluster of sterile bevacizumab-related uveitic reactions was described in this case series. Acute onset of symptoms, absence of hypopyon, a predominant anterior segment reaction, and prompt improvement on topical steroid therapy are useful clinical features distinguishing this uveitic syndrome from infectious endophthalmitis.

}, keywords = {Adult, Aged, Aged, 80 and over, Angiogenesis Inhibitors, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Bevacizumab, Humans, Immunosuppressive Agents, Intravitreal Injections, Middle Aged, Retrospective Studies, Uveitis, Anterior, Vascular Endothelial Growth Factor A, Visual Acuity}, issn = {1938-2375}, doi = {10.3928/15428877-20110603-04}, author = {Kay, Christine N and Tarantola, Ryan M and Gehrs, Karen M and Folk, James C and Mahajan, Vinit B and Boldt, H Culver and Syed, Nasreen A and Russell, Stephen R} }