[Early antiexudative response--OCT monitoring after intravitreal bevacizumab injection]

Abstract

VEGF is more potent than histamine by a factor of 50,000 for inducing increased vessel permeability. Already in the first few minutes, hydraulic conductivity and diffusive permeability are significantly increased, followed by a longer-lasting, marked leakage over 20 h. Specific inhibition of the angiogenic, vasoactive, and permeability-inducing protein VEGF is now possible by new drugs, one of which is the first available (off-label) treatment in Germany for routine clinical use (Avastin). Retinal edema is composed of increased outflow of water and low molecular substances in the interstitial environment and is an important determinate of functional development in different ocular diseases. First experiences with the anti-hyperpermeability effect show early response and high potential in pathologic leakage. Future examinations have to assess when a permanent benefit can be achieved in respect to the other antiproliferative capabilities of the drug.