I have seen a significant number of retinal detachments following Avastin monotherapy. I believe the recurrences are extremely atypical. They show a different morphology and often a different location. The recurrences often appear as vascular tangles and growths without any fibrous tissue and often occur well posterior to the junction of the vascular and avascular retina. They seem to be near the original site of stage 3. The early subtle recurrences may not occur until 8 weeks following the injection! In order to see the vascular proliferation careful examination with indirect ophthalmoscopy and 20 diopter lens are needed. Mike Blair, MD and I, have a letter to the editor in press, describing the first detachment referred and hope to submit a series ASAP.
I consider close observation mandatory until about 80 weeks PMA. Many of my own cases have had reinjection or laser.
I am working on a log without identifiers to track the regression and recurrence pattern after Avastin. Dear readers please beware; this is a lovely treatment but still carries potential dangers. Please use with caution.
