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R. A. Garcia-Amaris, J. G. Sanchez, L. Wu, M. H. Berrocal, M. Maia, J. Arevalo; Primary Intravitreal Bevacizumab for the Management of Pseudophakic Cystoid Macular Edema: 6-Months Follow-Up. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4156.
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To determine the feasibility, safety and clinical effect of primary intravitreal (IVT) bevacizumab (Avastin) in patients with cystoid macular edema (CME) after cataract surgery.
Twenty-eight eyes of 25 patients with a mean age of 67.1 years (range: 17 to 87 years) that were treated with at least one IVT injection of 1.25 mg or 2.5 mg of bevacizumab participated in this interventional retrospective multicenter study in 4 institutions from 4 countries. Patients underwent ETDRS visual acuity testing, optical coherence tomography (OCT) imaging, and ophthalmoscopic examination at baseline and follow-up visits. Patients had a mean follow-up of 32 weeks (range: 24 to 52 weeks).
Twenty eyes (71.4%) demonstrated improvement of best-corrected visual acuity (BCVA) (2 or more ETDRS lines) and no eyes experienced worsening of visual acuity (2 or more ETDRS lines). The best-corrected visual acuity (BCVA) remained stable in 8 eyes (28.6%). The mean baseline acuity was 20/160 (logMAR = 0.92) and the mean final acuity was 20/63 (logMAR = 0.52), a difference that was highly significant (p < 0.0001). The mean central macular thickness at baseline was 482.1 microns (range: 208 to 784 microns) and decreased to a mean of 274.8 microns (range: 176 to 513 microns) at the end of follow-up (p < 0.0001). Sixteen (57.1%) eyes received a single dose of bevacizumab, whereas eight (28.6%) eyes needed a second injection, and four (14.3%) needed a third injection. The mean interval between injections was 12.4 weeks (range: 5 to 26 weeks). No ocular or systemic adverse events were observed.
Short-term results suggest that primary IVT bevacizumab is well tolerated in patients with pseudophakic CME. Treated eyes with IVT bevacizumab had a significant improvement in BCVA and decrease in macular thickness by OCT. The number of patients in this study was limited and the follow-up is too short to make any specific treatment recommendations. The favorable results at 6 months suggest the need for further study with longer follow-up and a larger series of patients.
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