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Natalia Alpizar-Alvarez, Lihteh Wu; Long-Term Visual and Anatomical Outcomes of Patients with CME Secondary to BRVO Following Intravitreal Bevacizumab: Real World Experience from a Developing Country.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):168.
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<br /> To report the long-term anatomical and visual acuity outcomes of patients with CME secondary to BRVO following treatment with intravitreal bevacizumab (IVB).
A retrospective case series of 31 eyes with CME secondary to BRVO seen at the Instituto de Cirugía Ocular in Costa Rica that were treated with at least 1 IVB. The main outcome measured was the rate of change of visual acuity. Secondary outcomes included the changes in CMT and complications.
A total of 31 eyes of 31 patients with a mean age of 62.5 ± 13.0 years old (range 39-87) were included in the study. Patients were followed for a mean of 31.5 ± 38.2 months (Range 2-168 months). Seventeen were females and 14 were males. Sixteen (51.6%) had systemic hypertension (HTN) and one (3.2%) had diabetes mellitus. The BCVA at baseline was 0.7 ± 0.5 logMAR and the BCVA at the last follow up was 0.4 ± 0.4 logMAR (p=0.17). The rate of visual change from baseline to the last follow up was 0.57 logMAR person-year (p= 0.04). At baseline 25.8% (8/31) eyes had a BCVA ≥ 20/40, 48.3% (15/31) eyes had a BCVA between 20/40 and 20/200, and 25.8% (8/31) had a BCVA ≤ 20/200. At the final visit, 51.6% (16/31) eyes had a BCVA ≥ 20/40, 41.9% (13/31) eyes had a BCVA between 20/40 and 20/200, and 6.4% (2/31) had a BCVA ≤ 20/200.<br /> Mean CMT decreased from 477.4 ± 228.9 to 285.1± 114.2 µm (p=0.0001). At the last follow-up CME had resolved in 64.5% (20/31) eyes. Of these eyes 30% (6/20) did not exhibit a change in BCVA, 10% (2/20) lost ≥ 2 lines and 60% (12/20) gained ≥ 2 lines of BCVA. Patients with resolution of CME (logMAR 0.6 (20/80) had a significant improvement (p=0.04) in BCVA vs patients with persistent CME 0.78 logMAR (20/120). None of the patients developed ocular or systemic complications after the use of IVB.
Real world experience from a developing country shows that the long-term visual outcomes of eyes with CME secondary to BRVO treated with prn IVB is of visual benefit.
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