Purchase this article with an account.
M. Rabena, D.J. Pieramici, A.A. Castellarin, M.A. Nasir, M.J. Giust, R.L. Avery; Intravitreal Bevacizumab (Avastin®) for Retinal Vein Occlusion . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5909.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To report the short–term safety and biological effect of intravitreal bevacizumab (Avastin®) in patients with central or branch retinal vein occlusion with macular edema and/or neovascularization.
This IRB approved, retrospective case study evaluated 17 eyes of 16 consecutive patients with retinal vein occlusion who received intravitreal bevacizumab and for which we had a minimum of 4 week follow–up. After preparation of the eye using 5% povidone/iodine and topical antibiotics, 1.25mg (0.05 ml) was injected intravitreally via the pars plana. Patients were re–examined one week and one month post–injection. Evaluation included nonstandardized Snellen visual acuity, complete ophthalmic examination, fluorescein angiography, and/or optical coherence tomography (OCT). Patients were re–injected on a monthly basis (at different intervals ranging from 1 to 2 months) until macular edema or subretinal fluid resolved.
Three central and 14 branch retinal vein occlusion eyes received intravitreal bevacizumab (1.25 mg). Of the 16 patients, 10 were female and 6 were male. The mean age was 66 years. Follow up ranged from 4 to 12 weeks. No significant ocular or systemic side effects were observed. Most patients showed a reduction of retinal thickness by OCT beginning 1 week following injection. One eye which did not have pre– or post– injection OCT images was excluded from OCT analysis, but was noted to have improvement in visual acuity. At baseline and 4 weeks, the mean retinal thickness of the central 1 millimeter decreased 132 microns (p<0.005). In some cases the edema was located away from the central axis and retinal thickness is under–represented by central retinal OCT analysis. At 4 weeks following injection, 6 of 16 eyes demonstrated complete resolution of retinal edema. 4 of 16 eyes were re–injected 1 month and 3 eyes were re–injected 2 months after initial injection. Mean visual acuity improved from 20/250 to 20/160 (p<0.05). Angiography showed a reduction in retinal edema in most eyes. In one patient, angiography revealed the regression of retinal neovascularization 1 week after injection.
These short–term results demonstrate that the administration of intravitreal bevacizumab for retinal vein occlusion is well tolerated and is associated with an improvement in visual acuity and a reduction in retinal thickness. These early findings suggest a positive biologic effect on macular edema for intravitreal bevacizumab. Further study including the long–term follow–up of the potential role of intravitreal bevacizumab in the treatment of central or branch retinal vein occlusion is indicated.
This PDF is available to Subscribers Only