Some time patients claim improvement in fellow eye after intra-vitreal anti-VEGF injection
No, Avadesh, I have never came across improvement in the other eye of the patient specifically related to the intra-vitreal injection.
When its used in treatment of Aggressive Posterior Retinopathy of Prematurity, I have seen "beneficial" effect in the other eye.
Over 300 AMD cases I didint received similar feedback, maybe because more of them were in atrophic scare stage.
Using Bevacizumab it is possible to hear from patient a beneficial effect in the fellow eye if affected by neovascular amd as well. I have not unfortunately images to support this observation
Yes there is! It is well known that because of systemic levels there is an effect in the fellow eye! This was demonstrated years ago by Avery et al: Ophthalmology. 2006 Oct;113(10):1695.e1-15.
More recent studies:
Fellow eye effect of unilateral intravitreal bevacizumab injection in eyes with diabetic macular edema.
Hanhart J, Tiosano L, Averbukh E, Banin E, Hemo I, Chowers I; Medscape.
Eye (Lond). 2014 Jun;28(6):646-53. doi: 10.1038/eye.2014.94. Epub 2014 May 23.
Comparison of the effect of unilateral intravitreal bevacizumab and ranibizumab injection on diabetic macular edema of the fellow eye.
Bakbak B, Ozturk BT, Gonul S, Yilmaz M, Gedik S.
J Ocul Pharmacol Ther. 2013 Oct;29(8):728-32. doi: 10.1089/jop.2013.0049. Epub 2013 Jul 13.
Effects of intravitreally injected bevacizumab on vascular endothelial growth factor in fellow eyes.
Matsuyama K, Ogata N, Matsuoka M, Wada M, Nishimura T, Takahashi K.
J Ocul Pharmacol Ther. 2011 Aug;27(4):379-83. doi: 10.1089/jop.2010.0194.
The observation of a possible therapeutic effect in the fellow eye raises concern that systemic side effects are possible in patients undergoing treatment with intravitreal bevacizumab (1.25 mg), specially in diabetics.
Yes, I agre entirely with Dr Arevallo stated that "Yes there is! It is well known that because of systemic levels there is an effect in the fellow eye' This effect is more proiminent in case of off-label Avastin due to large molecule rapidly escaping into systemic blood circulation and reaching the fellow eye. This effect is evidence-based.
A phase II study of uniocular, topically applied, latanoprost showed significant IOP reduction in the fellow eye. So contralateral effects may be more common than you may expect from the total dose. Remember the unexpected findings with the systemic effects from topical beta-blockers...
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