Intravitreal bevacizumab is a medication injected directly into the eye to treat ocular disease. This medication inhibits angiogenesis, the growth of new blood vessels, and was originally approved for cancer treatment. Injections of the drug into the eye are an example of off-label use. A doctor may recommend this therapy if a patient appears to be a good candidate, based on the doctor's experience and understanding of how the drug works.
Off-label use of medications is very common. These uses are not approved by regulatory agencies, and studies have not been conducted to determine their safety and efficacy, or the appropriate dosage. Instead, doctors use existing information about the medication and dosing standards to develop a treatment plan for a patient. Analysis of off-label use of intravitreal bevacizumab demonstrates that it does not appear to be unsafe for patients, beyond the risks expected in the more elderly population that receives the drug.
One of the most common uses for intravitreal bevacizumab is in the treatment of age-related macular degeneration. Doctors may also recommend the drug for macular edema and other ocular conditions that are exudative or neovascular in nature. Exudative conditions involve buildups of fluid the cause swelling and discharge of liquid from the eye, while neovascular conditions are caused by the development of new blood vessels in the eye. The medication can suppress blood vessel growth and limit swelling to keep the patient comfortable and arrest any damage.
Some potential side effects of intravitreal bevacizumab can include scratches to the cornea, inflammation, infections, hemorrhage inside the eye, and retinal detachment. Serious side effects like retinal detachment are extremely low. A doctor with a good injection technique and years of practice can typically limit the risk of other side effects. Vision loss has been documented in some patients in association with the medication, but this is sometimes due to preexisting ocular issues, not to the drug.
When a doctor recommends intravitreal bevacizumab, the patient may want to ask why the doctor thinks the drug may be helpful, and which alternatives are available. Patients can also discuss concerns about side effects, and should make sure their doctors are aware of any history of allergic or other reactions to medication. It is also important to review all drugs currently being taken, including herbal supplements and medications bought over the counter, as these may potentially increase the risk of an adverse reaction to the bevacizumab.
