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Inner Retinal Changes in Acute Experimental BRVO Treated With Bevacizumab or Triamcinolone Acetonide
Ian L McAllister1,2,3, Sarojini Vijayasekaran1,2, Riyaz Bhikoo2,3
1Centre for Ophthalmology and Visual Science, The University of Western Australia, Perth, Australia.
Translational Vision Science & Technology
|February 8, 2023
Summary
Vascular endothelial growth factor (VEGF) antagonists like bevacizumab worsen neural damage in branch retinal vein occlusion (BRVO) models. Treatment timing and choice are critical for managing retinal vascular diseases.
Area of Science:
- Ophthalmology
- Neuroscience
- Vascular Biology
Background:
- Apoptosis contributes to neural degeneration in retinal vascular diseases.
- Vascular Endothelial Growth Factor (VEGF) antagonists, such as bevacizumab, are standard treatments for macular edema.
- VEGF plays a crucial role in maintaining retinal neuronal cell health.
Purpose of the Study:
- To investigate the impact of bevacizumab on neural damage in a pig model of branch retinal vein occlusion (BRVO).
- To compare the neuroprotective effects of bevacizumab with triamcinolone acetonide (TA), a known neuroprotective agent.
Main Methods:
- A photothrombotic BRVO model was induced in 36 pigs.
- Eyes were treated with bevacizumab or TA and analyzed at various time points (2, 6, 10, 20 days) using TUNEL, histology, and immunohistochemistry.
- Control groups included BRVO-only and normal pigs.
Main Results:
- Bevacizumab treatment led to significantly higher rates of apoptosis in the ganglion cell layer (GCL) and inner nuclear layer (INL) compared to TA.
- Increased pyknotic cells were observed in bevacizumab-treated eyes in the GCL and INL.
- Macrophage infiltration was present in all groups, with no significant difference between bevacizumab and TA treatments.
Conclusions:
- Current BRVO treatments, including VEGF suppression with bevacizumab, can exacerbate neurodegeneration in the acute phase.
- Findings suggest that the timing and type of treatment for BRVO are critical and may need re-evaluation.
