Volume 113, Issue 10, Pages 1695-1705.e6 (October 2006) Intravitreal Bevacizumab (Avastin) in the Treatment of Proliferative Diabetic Retinopathy  Robert L. Avery, MD, Joel Pearlman, MD, PhD, Dante J. Pieramici, MD, Melvin D. Rabena, BS, Alessandro A. Castellarin, MD, Ma’an A. Nasir, MD, Matthew J. Giust, CRA, Robert Wendel, MD, Arun Patel, MD  Ophthalmology  Volume 113, Issue 10, Pages 1695-1705.e6 (October 2006) DOI: 10.1016/j.ophtha.2006.05.064 Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 1 Case 3. Color, midphase, and late-phase fluorescein angiograms and iris angiograms at (A) baseline and (B) 1 week after intravitreal injection of 1.25 mg of bevacizumab. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 2 Case 13A. Red-free (A), midphase (B), and late-phase (C) angiograms at baseline and red-free (D), midphase (E), and late-phase (F) angiograms 1 week after intravitreal injection of 1.25 mg of bevacizumab. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 3 Case 20A. Red-free, midphase, and late-phase fluorescein angiograms and iris angiograms at (A) baseline and (B) 1 week after intravitreal injection of 1.25 mg of bevacizumab. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 4 Case 20B. Red-free, midphase, and late-phase fluorescein angiograms at (A) baseline and (B) 1 week after intravitreal injection of 125 μg of bevacizumab. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 5 Case 27. Red-free (A), midphase (B), and late-phase (C) angiograms at baseline and red-free (D), midphase (E), and late-phase (F) angiograms 3 weeks after intravitreal injection of 1.25 mg of bevacizumab. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 6 Case 19A. Red-free and midphase fluorescein angiograms of the optic nerve and temporal midperiphery and late-phase fluorescein angiogram at (A) baseline; (B) 1 week after intravitreal injection of 12.5 μg of bevacizumab; (C) 4 weeks after initial injection, at which time 1.25 mg was reinjected; and (D) 1 day after the second injection. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 7 Case 6A. Fluorescein angiogram montage before treatment showing extensive neovascularization and macular edema. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 8 Case 6A. Fluorescein angiogram montage 1 week after injection of 1.25 mg of bevacizumab showing reduction in the leakage of neovascularization and macular edema. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 9 Case 6A. Fluorescein angiogram montage 2 weeks after injection of 1.25 mg of bevacizumab showing a partial return in the leakage of neovascularization and macular edema. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 10 Case 14A. Midphase and late-phase fluorescein angiograms at (A, B) baseline and (C, D) 6 weeks after intravitreal injection of 1.25 mg of bevacizumab. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 11 Case 14A. Horizontal and vertical optical coherence tomography images at (A, B) baseline and (C, D) 6 weeks after intravitreal injection of 1.25 mg of bevacizumab. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 12 Case 14A. Iris angiograms of the left eye (A–C) and right eye (D–F). At baseline, there is mild iris neovascularization in the left eye (A), for which an injection of 1.25 mg of bevacizumab was given, and there is florid iris neovascularization in the fellow right eye (D). Four weeks later, the iris neovascularization in the injected left eye has resolved (B), and there is a suggestion that there is less leakage in the fellow right eye (E), which was then injected with 1.25 mg of bevacizumab. Six weeks after the injection for the left eye, there is no recurrence (C). The leakage in the right eye (F) partially resolved 2 weeks after it received an injection. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 13 Case 12. Regression of neovascularization of the disc in the fellow untreated eye. At baseline, a fluorescein angiogram demonstrates (A) active areas of neovascularization elsewhere in the right eye and (B) neovascularization of the disc in the left eye. One week after intravitreal injection of 1.25 mg of bevacizumab in the right eye, there are (C) complete resolution of the leakage in the right eye and (D) a reduction in the leakage in the untreated left eye. Two weeks after injection in the right eye, the neovascularization (E) remains undetectable in the right eye but (F) recurs in the fellow untreated eye. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 14 Case 12. Baseline neovascularization of the disc in the fellow untreated eye. Top, Color and red-free images before injection of the fellow eye. Bottom, Midphase and late-phase fluorescein angiograms demonstrating leakage of neovascularization of the disc. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 15 Case 12. Resolution of neovascularization of the disc in the fellow untreated eye. Top, Color and red-free images 1 week after injection of 1.25 mg of bevacizumab to the fellow eye. Bottom, Midphase and late-phase fluorescein angiograms demonstrating resolution of neovascularization of the disc leakage in this eye after injection of the fellow eye. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 16 Case 22. Mid-phase fluorescein angiograms of (A) superior and (B) temporal midperiphery at baseline and (C, D) 1 week after intravitreal injection of 62.5 μg of bevacizumab. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 17 Case 30. Midphase and late-phase fluorescein angiograms at (A) baseline and (B) 1 week after intravitreal injection of 6.2 μg of bevacizumab. A reduction in leakage of neovascularization of the disc is noted. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 18 Case 32. Montage color photographs (left) at baseline and (right) 1 week after intravitreal injection of 1.25 mg of bevacizumab. There is a reduction in caliber of many of the abnormal new vessels. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 19 Case 32. Red-free, midphase, and late-phase fluorescein angiograms at (A) baseline and (B) 1 week after injection. Some large-bore abnormal vessels remain perfused after injection but are of smaller caliber and do not leak fluorescein dye. There is persistent leakage only at the optic nerve head. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions

Figure 20 Case 32. Intraoperative appearance during cutting of the dense fibrovascular tissue superior and nasal to the optic nerve head. The intraocular pressure was 20 mmHg during the cutting, yet very little bleeding was observed. Ophthalmology 2006 113, 1695-1705.e6DOI: (10.1016/j.ophtha.2006.05.064) Copyright © 2006 American Academy of Ophthalmology Terms and Conditions