Bevacizumab (Avastin)
Definition / Overview
Bevacizumab is a full-length humanized monoclonal antibody against all isoforms of VEGF-A. Used off-label in ophthalmology as an intravitreal anti-VEGF agent for a wide range of retinal vascular conditions. The most widely used anti-VEGF agent globally due to its low cost.
Key Details
- Mechanism: Binds all isoforms of VEGF-A, preventing receptor activation â reduces vascular permeability, inhibits neovascularization
- Administration: intravitreal-injections, typically 1.25 mg/0.05 mL
- Molecular weight: ~149 kDa (full-length antibody â larger than ranibizumab fragment)
- Key trials: CATT, IVAN, LUCAS â details to be added from dedicated sources
Clinical Relevance
In the context of retinal-arterial-macroaneurysm: Pichi et al. (2013) demonstrated reduction in macular edema and hard exudates in all 38 eyes with RAM-associated macular complications treated with intravitreal bevacizumab. Evidence is promising but not extensive.
Other major indications (to be expanded): wet amd, diabetic-retinopathy/DME, RVO-associated macular edema, ROP.
Associations
- ranibizumab â Fab fragment of same parent antibody; see future comparison bevacizumab-vs-ranibizumab
- retinal-arterial-macroaneurysm â emerging treatment for macular edema
- intravitreal-injections â delivery method
Sources
- macroaneurysm-eyewiki (limited to RAM context)
Gap: This page needs dedicated sources covering mechanism of action in depth, landmark trials (CATT, IVAN, LUCAS), comparative efficacy, safety profile, and dosing regimens across indications.