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M. K. George, R. A. Adelman; Effect of Intravitreal Bevacizumab on Macular Edema Secondary to Retinal Vein Occlusions. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5405.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effect of Bevacizumab on macular edema secondary to central and branch retinal vein occlusions.
Retrospective study of 19 patients with macular edema secondary to retinal vein occlusions. Patients were evaluated at baseline using Optical Coherence Tomography (OCT) and Fluorescein Angiography (FA) and given 3 consecutive intravitreal injections of Bevacizumab every 4-6 weeks and followed clinically and using OCT. Further injections were administered on follow up visits if persistent edema was noted. Patients who received any other concurrent treatment modality were excluded from the study. OCTs were evaluated for edema and intraretinal cysts and graded from 0-4 by a masked examiner. Primary end points included visual acuity, central macular thickness (CMT), grade of cyst and edema after one injection, three injections and at the end of follow up. Statistical analyses were done with paired T-tests and ANOVA using SPSS 13.0
A total of 19 patients (mean age 60) were followed for an average of 9 months. There was -0.21 (p=0.025), -0.29 (p=0.000) and -0.35 (p=0.018) improvement in logMAR visual acuity seen after the first and third injections and at the end of follow up respectively. There was a significant reduction of mean CMT from a baseline of 455µ to 274µ (p=0.000) after the first injection, to 305µ (p=0.015) following three injections and to 231µ (p=0.024) at the end of follow up. We also noted a statistically significant reduction in intraretinal cyst grading (one injection 1.3; p=0.000; three injections 1.5; p=0.004; end of follow up 1.7; p=0.026) and edema grading at all end points (one injection 1.6; p=0.000; three injections 1.5; p=0.006; end of follow up 1.9; p=0.003). The initial grade of macular edema was not significantly associated with the final visual acuity or edema at the end of follow up.
Intravitreal injection of Bevacizumab leads to clinically significant reduction in macular edema and intraretinal cysts as well as improvement in visual acuity upto 9 months. Benefits from the intervention begins with the first injection and persists with subsequent injections.
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