Rebound neovascularization during bevacizumab therapy

Area of Science:

• Ophthalmology
• Retinal Diseases
• Pharmacology

Background:

• Neovascularization is a hallmark of several retinal diseases.
• Bevacizumab is an anti-vascular endothelial growth factor (VEGF) agent used to treat neovascularization.
• The long-term effects of discontinuing bevacizumab treatment require further investigation.

Purpose of the Study:

• To report two cases of rebound neovascularization following intravitreal bevacizumab therapy.
• To highlight the potential for severe neovascularization upon cessation of bevacizumab treatment.

Main Methods:

• Retrospective case report of two patients.
• Patients diagnosed with proliferative diabetic retinopathy and central retinal vein occlusion.
• Treatment involved panretinal photocoagulation and intravitreal bevacizumab.

Main Results:

• Initial treatment led to significant regression of neovascularization in both patients.
• Discontinuation of bevacizumab resulted in massive neovascularization, exceeding initial severity.
• Rebound neovascularization occurred after treatment cessation due to loss to follow-up.

Conclusions:

• Bevacizumab can induce a rebound neovascularization phenomenon after initial suppression of VEGF.
• This rebound effect can be more severe than the original presentation.
• Careful monitoring is crucial after bevacizumab treatment cessation.