gms | German Medical Science

22nd International Congress of German Ophthalmic Surgeons

18. to 21.06.2009, Nürnberg

Fibrosis and Angiogenesis after Intravitreal Bevacizumab for Proliferative Diabetic Retinopathy (PDR): Increase or Regress?

Meeting Abstract

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  • Narcisa Ianopol - Railway Clinic Hospital, Ophthalmologic Department, Iasi, Romania
  • Bernd Kirchhof - Center of Ophthalmology, Vitreo-retinal Surgery Department, Cologne, Germany

22. Internationaler Kongress der Deutschen Ophthalmochirurgen. Nürnberg, 18.-21.06.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09docPO 3.5

DOI: 10.3205/09doc057, URN: urn:nbn:de:0183-09doc0572

Published: July 9, 2009

© 2009 Ianopol et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Purpose: To analyze the evolution of fibrosis and angiogenesis after intravitreally injected Bevacizumab in PDR.

Methods: Eyes with proliferative diabetic retinopathy were intravitreally injected with 1.25 mg Bevacizumab per injection, 1 month interval between injections. The extension of fibrotic tissue and neovascular network has been quantified on red free and fluorescein angiography images, by using an algorithm that calculates the number of pixels covered by “white lesions”. The measurements were performed inside of the same preestablished area of the ocular fundus images, before- and different periods of time after Bevacizumab injections. The aspect of posterior hyaloid and proliferative epiretinal membranes was observed during vitrectomy on eyes intravitreally injected with Bevacizumab. Selected video sections will be displayed on the poster video-section.

Results: The quantification in pixels on red free and angiographic images revealed that neovascular network regresses after intravitreal Bevacizumab, even from the first 4–7 days after treatment and continues after further intravitreal injections. The fibrosis seems also to regress, as the result of the following suspected processes: new vessels occlusion and breakdown of new vessels walls, shrinkage and contraction of the fibrotic strands, increasing the fibrotic tissue density. However the video images in all Bevacizumab injected eyes observed during vitrectomy show that posterior hyaloid appears fibrotic and the epiretinal proliferative membranes strengthen, suggesting that Bevacizumab may increase the fibrosis.

Conclusions: Intravitreal Bevacizumab leads to regression of the angiogenesis and fibrosis, but the exact contribution of each process in the pathogenic chain is difficult to be established on the living human eyes. Further methods of evaluation are required for much more accurate assessment of both fibrosis and angiogenesis.