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To the Editor:
We thank Sherman et al.1 for their report on the potential side effect of optic neuropathy in patients with glioblastoma being treated with bevacizumab. We would like to highlight some considerations.
Data on the use of bevacizumab for systemic cancer and high-grade gliomas have not shown a side effect of bevacizumab-induced optic neuropathy.2 Additionally, a review of bevacizumab in patients with brain metastases treated with radiotherapy did not report this complication.3 Finally, in our experience of treating 200 patients with high-grade gliomas with bevacizumab, there were episodes of optic neuropathy but they were explained by alternative mechanisms.4
Bevacizumab and related antiangiogenic inhibitors have been widely used for choroidal neovascularized retinopathies and specifically age-related macular degeneration.5 Experience suggests that the intravitreal administration of these agents has been effective and safe, and rarely results in anterior optic neuropathy.
Radiotherapy of the anterior optic apparatus is associated with delayed late radiation injury patterns including cataracts, …
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