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C. C. Patel, J. E. Puklin; The Impact of the Interval Between Symptom Onset and Intravitreal Bevacizumab Injection for Treatment of Macular Edema From Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2007;48(13):304.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the impact of the interval between symptom onset and intravitreal bevacizumab injection for treatment of macular edema from retinal vein occlusion(RVO).
Retrospective chart review of consecutive patients treated with intravitreal bevacizumab for macular edema due to CRVO or BRVO was performed. Eyes having two or more optical coherence tomography(OCT) measurements, with one on day of injection were included. Response to injection was calculated as a percent change from initial central foveal thickness. Initial, best and final OCT values were tabulated.Patients were stratified based on time between symptom onset and injection of bevacizumab; Group 1 ≤ 100 days, Group 2 between 101-399 days, and Group 3 > 400 days. A paired t-test was used to compare mean pre and post-injection OCT thickness for each group. ANOVA was used to compare the mean percent change in OCT thickness between the groups.
16 patients met inclusion criteria. They were injected on average 2.2 (group 3) to 2.6 (group 1) times. Mean central foveal thickness decreased from 483.8µm to 301.8µm(best) and 335.2µm(final) for Group 1; from 344.8µm to 261.4µm(best) and 284.8µm(final) for Group 2; and from 334.5µm to 307.8µm(best) and 405.2µm(final) for Group 3. A paired t-test showed a significant change in foveal thickness for group 1 from initial to best OCT value, but not for any of the other groups. ANOVA found no significant difference in the mean percent change in foveal thickness for the 3 groups from initial to best(P=0.168) or final(P=0.164) OCT values. Patients in group 1 achieved greatest foveal change earlier(43.4 days) than other groups.
Intravitreal bevacizumab injection resulted in a significant decrease in central foveal thickness in eyes injected within 100 days of symptom onset. There was worsening of final foveal thickness in eyes injected more than 400 days after symptom onset. The other groups showed a decrease in foveal thickness that was not statistically significant. These results suggest early administration of bevacizumab after RVO may improve final central foveal thickness.
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