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K. Kriechbaum, S. Michels, F. Prager, M. Georgopoulos, M. Funk, K. Polak, C. Hirn, U. Schmidt-Erfurth; Intravitreal Bevacizumab (Avastin®) in Retinal Vein Occlusion - A Six Months Follow Up. Invest. Ophthalmol. Vis. Sci. 2007;48(13):308.
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To evaluate efficacy and safety of intravitreal bevacizumab (Avastin®) in eyes with macular edema due to retinal vein occlusion.
A prospective non-controlled study, approved by the ethics committee at the Medical University of Vienna and registered at the European clinical database (EUDRACT), enrolled patients with macula edema due to central or branch retinal vein occlusion, having an initial visual acuity (VA) between 20/400 and 20/32 (snellen equivalent) and a central retinal thickness (CRT) of > 250 µm as measured by optical coherence tomography (OCT). All patients initially received three intravitreal injections of 1 mg bevacizumab as 0.04 ml at 4 week intervals. Thereafter, further retreatment was based on OCT. Follow-up examinations including VA using ETDRS charts (VAS, visual acuity score), OCT, microperimetry and fluorescein angiography (FA) were done at day 1, 7 and 28 after first injection, and at monthly intervals thereafter.
Twenty-nine patients were enrolled into the study. Seven eyes showed a central, 22 a branch retinal vein occlusion. Baseline median CRT (N = 29) in OCT was 517 µm and median VA was 50 VAS (Sn 20/50). Most eyes already showed a decrease of CRT one day after first injection (p < 0.01). Three injections induced a reduction of macular edema as documented clinically and by FA as well as a significant decrease of CRT to 313 µm (p < 0.01). Median VA improved significantly (p < 0.01) to 66 VAS (Sn 20/25). Using an OCT based treatment regimen functional and anatomic results were stabilized at month 6. Median CRT was stable at 322 µm (p > 0.05, N = 16) and median visual acuity improved further (p > 0.05) to 70 VAS (20/20). FA showed no evidence of increased avascular zones despite anti-VEGF therapy. No severe local or systemic adverse events were seen in follow-up.
Intravitreal injections of bevacizumab appear to be a safe and effective therapeutic option in macular edema due to retinal vein occlusion.
European clinical database (EUDRACT)
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