Intravitreal bevacizumab (Avastin) in proliferative diabetic retinopathy

Acta Ophthalmol. 2008 Sep;86(6):683-7. doi: 10.1111/j.1600-0420.2007.01042.x.


Purpose: To evaluate the efficacy and safety of intravitreal bevacizumab in proliferative diabetic retinopathy (PDR) patients.

Methods: This interventional case series study included 15 eyes of 10 patients with bilateral PDR: 13 eyes with severe PDR and active new vessels (NV) and two eyes with recurrent vitreous haemorrhages. Study eyes received a single intravitreal injection of 1.25 mg (0.05 ml) bevacizumab. All eyes were followed up for 3 months, and eight of them for 9 months. Reinjection was performed in three eyes 4-6 months after the first injection. Study eyes were evaluated by fluorescein angiography at baseline, 1, 3 and 9 months. Quantitative planimetric analysis (QPA) of NV area was measured before and after treatment. All eyes received or completed panretinal photocoagulation (PRP) 1 month after the first injection.

Results: As early as at 1 month, all study eyes had a regression (paired t-test, P = 0.01) of QPA-estimated NV area. The eyes with recurrent vitreous haemorrhages had clearing of bleeding. These early effects were maintained at 3 months for all eyes and tended to be stable at 9 months. The fast and measurable efficacy of bevacizumab allowed a subsequent complete and safe PRP.

Conclusion: Intravitreal bevacizumab did not reveal any side-effects and was effective in the regression of NV areas and the resolution of vitreous haemorrhages. This approach is potentially useful in allowing (within a planned temporal window) a safe and efficient PRP to be performed while minimizing the risk of its complications.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Angiogenesis Inhibitors / adverse effects
  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Diabetic Retinopathy / diagnosis
  • Diabetic Retinopathy / drug therapy*
  • Female
  • Fluorescein Angiography
  • Humans
  • Injections
  • Male
  • Middle Aged
  • Recurrence
  • Retinal Neovascularization / diagnosis
  • Retinal Neovascularization / drug therapy*
  • Retreatment
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Vitreous Body
  • Vitreous Hemorrhage / diagnosis
  • Vitreous Hemorrhage / drug therapy*


  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Vascular Endothelial Growth Factor A
  • Bevacizumab