Track topics on Twitter Track topics that are important to you
To assess the use of Avastin for the management of serosanguinous maculopathy
Patients will be recruited from the vitreoretinal clinics at SNEC. After initial assessment, clinically and angiographically, the patient will be counselled with regards to diagnosis, prognosis and management options, including the option of intravitreal Avastin.
1. All subfoveal/juxtafoveal CNV and PCV (polypoidal choroidal vasculopathy) who are not eligible for other treatment options (compassionate use)
2. CNV and PCV lesions which have failed PDT, conventional argon laser photocoagulation (salvage use)
3. CNV and PCV lesions treatable with PDT, but cannot afford or refused
1. Patients with uncontrolled hypertension (systolic BP greater than 150mmHg or diastolic BP greater than 90mmHg
2. History of thrombolic events such as myocardial infarction or cerebral vascular accident
3. Renal abnormalities as defined by established history of chronic renal disease or renal failure as well as patients requiring dialysis
4. Recent (as defined as the past 28 days) or planned (as defined as the next 3 months) surgery.
5. Coagulation abnormalities, including anti-coagulant medication other than aspirin
6. Patients with peptic ulcer disease
7. Pregnant or lactating females
If the patient is agreeable to the intravitreal treatment protocol, he/she will be assessed systemically for fitness for the therapy. The serosanguinous maculopathy will be subtyped by angiographic findings to predominantly classic (>50% classic component) lesions, minimally classic (<50% classic component) lesions, occult lesions and polypoidal choroidal vasculopathy (PCV).
If the patient is eligible for the intravitreal treatment protocol, he/she will receive 1mg of Avastin intravitreally. This will be performed under aseptic technique. (See attached 'Intravitreal Injection Protocol'). The injections will be repeated every 8-10 weeks for a total of 3 treatments.
END OF TREATMENT
If the central retinal thickness is reduced by >50%, or if there is imrpovement/stablisiation of vision, or if an adverse effect (such as elevation of BP) is encountered, the treating physician can elect to withhold the Avastin treatment.
On review at the 8 and 16 weeks, the physician can elect to perform additional intravitreal Avastin treatment if any of the following should arise
1. Loss of VA of at least 5 letters at 2 sequential visits within 2 weeks, which is associated with increased leakage from the CNV seen on angiography or OCT
2. Increase in OCT central retinal thickness by >100um
3. Onset of a new macular haemorrhage
4. Development of a new classic CNV membrane
5. Ocular outcome measurements
6. Change from baseline in VA, i.e. gain or loss of 5 letters (1 line), 15 letters (3 lines) or 30 letters (6 lines)
1. Change in OCT measured central retinal thickness
2. Correlation in change in central retinal thickness and change in VA
Once informed consent has been obtained for intravitreal Avastin therapy, the patient will be assessed for the fitness to indergo the treatment. Baseline systemic & ocular assessments will be performed. Systemic assessment will include blood pressure measurement, electrocardiogram (ECG) and blood investigations (full blood count, prothrombin time, partial thromboplastin time, bleeding time)
Once deemed fit, the patient will receive Injection 1 of intravitreal Avastin (Refer Intravitreal Injection Protocol)
The patient will then be reviewed at 1 week post-injection and then monthly for the first 2 months. Investigations at these visits will include logMAR BCVA, biomicroscopy, FFA and OCT.
At the time point of 8-10 weeks, the patient will undergo Injection 2. Followed by review at 1 week post-injection and monthly for 2 months with the same investigations as stated above.
At 16-20 weeks, the patient will receive the last treatment, Injection 3, with similar post-injection visits and investigations.
If the central retinal thickness is reduced by >50%, or if there is imrpovement/stablisiation of vision, or if an adverse effect (such as elevation of BP) is encountered, the treating physician can elect to withhold the second and/or third Avastin treatment. Hence, each patient will receive at least 1 injection of Avastin and up to a maximum of 3 injections.
Allocation: Non-Randomized, Control: Uncontrolled, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Bevacizumab (tradename: Avastin)
Active, not recruiting
Singapore National Eye Centre
Published on BioPortfolio: 2014-08-27T03:43:49-0400
Our hypothesis is that this study design, in which bevacizumab is added to one of six single agent chemotherapies with proven activity in metastatic breast cancer, will result in regressio...
The primary purpose of the study is to investigate whether patients with Choroidal Neovascularization secondary to Age-related Macular Degeneration, receiving triple or double therapy comp...
The purpose of this study is to see if the drug bevacizumab is safe and effective to use for people with choroidal neovascularization (CNV). CNV is an eye condition where abnormal blood v...
Age related macula degeneration is one of the most common sight threatening diseases of the elderly. The so called wet form of AMD is caused by choroidal neovascularisation (CNV) of pathol...
This study is designed to provide efficacy and safety data in patients with choroidal neovascularisation (CNV) secondary to myopia using an individualized as-needed (PRN) dosing schedule. ...
Swept-source optical coherence tomography angiography (SS-OCTA) was used to diagnose choroidal neovascularization (CNV) arising from a choroidal nevus. A 61-year-old woman initially presented with sub...
The authors report a case of a congenital hypertrophy of the retinal pigment epithelium (CHRPE) associated with choroidal neovascularization (CNV) causing symptomatic vision loss. Two intravitreal inj...
Bevacizumab, a recombinant humanized monoclonal antibody to inhibit tumour-angiogenesis is available for off-label use for treating choroidal neovascularisation. Outbreaks have been reported after use...
The vascular endothelial growth factor antibody bevacizumab (Avastin®), received approval for the treatment of recurrent glioblastoma in many countries including the US and Switzerland, but not the E...
To demonstrate how a patient with recurrent episodes of choroidal neovascularization (CNV), secondary to angioid streaks, can be managed successfully with a pro re nata regime of intravitreal bevacizu...
An anti-VEGF recombinant monoclonal antibody consisting of humanized murine antibody. It inhibits VEGF receptors and prevents the proliferation of blood vessels.
A pathological process consisting of the formation of new blood vessels in the CHOROID.
Excessive axial myopia associated with complications (especially posterior staphyloma and CHOROIDAL NEOVASCULARIZATION) that can lead to BLINDNESS.
Disorders of the choroid including hereditary choroidal diseases, neoplasms, and other abnormalities of the vascular layer of the uvea.
A form of RETINAL DEGENERATION in which abnormal CHOROIDAL NEOVASCULARIZATION occurs under the RETINA and MACULA LUTEA, causing bleeding and leaking of fluid. This leads to bulging and or lifting of the macula and the distortion or destruction of central vision.
Cardiology is a specialty of internal medicine. Cardiac electrophysiology : Study of the electrical properties and conduction diseases of the heart. Echocardiography : The use of ultrasound to study the mechanical function/physics of the h...