Article
VEGF levels in serum and breast milk after repeated intravitreal injection of Bevacizumab and Ranibizumab – a case report
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Published: | June 29, 2009 |
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Purpose: to measure VEGF expression in serum and breast milk after repeated intravitreal injection of Bevacizumab or Ranibizumab in a nursing 33-year-old woman with choroidal neovascularisation secondary to a chorioretinal scar.
Methods: detection of VEGF in serum and breast milk samples before and after intravitreal injection of VEGF-inhibitors by ELISA.
Results: VEGF serum levels were significantly decreased after intreavitreal injection of Bevacizumab for about 8 weeks after injection and recovered slowly. VEGF concentration in breast milk was reduced by 30%, though VEGF is still present at high levels. After intravitreal Ranibizumab, however, serum and breast milk levels only showed a temporary downregulation after three days and recovered to preinjection levels after one week.
Conclusion: In principle, intravitreal injection of VEGF inhibitors should be avoided in nursing mothers. However, if anti-VEGF-treatment is unavoidable, Ranibizumab has a significantly lower effect on physiological levels of VEGF in serum and breast milk than Bevacizumab and should therefore be preferred.