Original article
Serum Concentrations of Bevacizumab (Avastin) and Vascular Endothelial Growth Factor in Infants With Retinopathy of Prematurity

https://doi.org/10.1016/j.ajo.2011.07.005Get rights and content

Purpose

To determine the serum concentrations of bevacizumab and vascular endothelial growth factor (VEGF) in infants with retinopathy of prematurity (ROP) who received intravitreal bevacizumab; and to determine whether the changes in the serum concentration of bevacizumab were significantly correlated with the serum concentration of VEGF after intravitreal bevacizumab.

Design

Case series.

Methods

Eleven infants (4 girls and 7 boys) with ROP were studied. They received 0.25 mg or 0.5 mg of intravitreal bevacizumab to either 1 eye (unilateral cases) or both eyes (bilateral cases) with vascularly active ROP. Serum samples were collected before and 1 day, 1 week, and 2 weeks after the intravitreal bevacizumab. The serum concentrations of bevacizumab and VEGF were measured by enzyme-linked immunosorbent assay, and the correlation in the serum levels between the 2 was determined.

Results

The serum concentration of bevacizumab before and 1 day, 1week, and 2 weeks after a total of 0.5 mg of intravitreal bevacizumab was 0 ng/mL, 195 ± 324 ng/mL, 946 ± 680 ng/mL, and 1214 ± 351 ng/mL, respectively. The serum bevacizumab level before and 1 day and 1 week after a total 1.0 mg of intravitreal bevacizumab was 0 ng/mL, 248 ± 174 ng/mL, and 548 ± 89 ng/mL, respectively. The serum concentration of VEGF before and 1 day, 1 week, and 2 weeks after a total of 0.5 mg intravitreal bevacizumab was 1628 ± 929 pg/mL, 427 ± 140 pg/mL, 246 ± 110 pg/mL, and 269 ± 157 pg/mL, respectively. There was a significant negative correlation (r = −0.575, P = .0125) between the serum concentration of bevacizumab and VEGF when a total of 0.25 mg or 0.5 mg of bevacizumab was injected.

Conclusions

These results indicate that bevacizumab can escape from the eye into the systemic circulation and reduce the serum level of VEGF in infants with ROP. Continued extensive evaluations of infants are warranted for possible effects after intravitreal bevacizumab in ROP patients.

Section snippets

Methods

The fundus of infants with ROP was examined with a slit lamp and contact lens (Volk Quad Pediatric Lens; Volk Optical Inc, Mentor, Ohio, USA) under general anesthesia. During the examinations, fundus photographs and fluorescein angiograms were taken with a RetCam 120 digital fundus camera (Clarity Medical Systems, Inc, Pleasanton, California, USA). The stage of the ROP was based on the International Classification of Retinopathy of Prematurity.16 The ROP eyes were also classified into 3 groups

Results

Eleven infants (4 girls and 7 boys) with highly vascular-active ROP were studied. The demographics of the patients are summarized in Table 1. Three patients received intravitreal bevacizumab in 1 eye and the other 8 received intravitreal bevacizumab in both eyes. The mean gestational age of the infants was 25 weeks (range, 23–27 weeks), and the mean body weight at birth was 660 grams (range, 332–1042 grams). All of the infants had received laser photocoagulation of the peripheral avascular

Discussion

Our results showed that the serum bevacizumab level was significantly higher at 1 week after than before the intravitreal bevacizumab in the ROP infants who received a total of 0.5 mg or 1.0 mg of intravitreal bevacizumab. In addition, the serum VEGF level was significantly lower at 1 week after than before the intravitreal bevacizumab in the ROP infants who underwent a total of 0.5 mg of intravitreal bevacizumab. Our results showed that there was a significant negative correlation between the

Tatsuhiko Sato, MD, received his medical degree from Osaka University Medical School, Osaka, Japan, in 2001. He completed residency at Osaka University Hospital. Now he is an attending staff in Ophthalmology at Osaka Rosai Hospital. His field of interest includes surgical treatment of vitreoretinal disease such as diabetic retinopathy, retinal detachment, and retinopathy of prematurity.

References (25)

  • R.L. Avery et al.

    Intravitreal bevacizumab (Avastin) for neovascular age-related macular degeneration

    Ophthalmology

    (2006)
  • R.L. Avery et al.

    Intravitreal bevacizumab (Avastin) in the treatment of proliferative diabetic retinopathy

    Ophthalmology

    (2006)
  • Cited by (0)

    Tatsuhiko Sato, MD, received his medical degree from Osaka University Medical School, Osaka, Japan, in 2001. He completed residency at Osaka University Hospital. Now he is an attending staff in Ophthalmology at Osaka Rosai Hospital. His field of interest includes surgical treatment of vitreoretinal disease such as diabetic retinopathy, retinal detachment, and retinopathy of prematurity.

    View full text