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Dhariana Acon, Lihteh Wu; Long-Term Visual and Anatomical Outcomes of Patients with Macular Edema Secondary to Central Retinal Vein Occlusion Following Intravitreal Bevacizumab: Real World Experience from a Developing Country. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):3747.
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© ARVO (1962-2015); The Authors (2016-present)
To report the long term anatomical and functional outcomes following prn treatment with intravitreal bevacizumab (IVB) of eyes diagnosed with CME secondary to CRVO. <br />
<br /> This is a retrospective case series of 70 eyes (67 patients) diagnosed with CME secondary to CRVO at a retina referral practice in Costa Rica. All patients underwent BCVA testing, slit lamp examination, funduscopic examination and OCT. All eyes were treated with at least 1 IVB. The main outcome measured was the rate of visual change following IVB. Secondary measures included rate of complications and changes in CMT.<br />
41 females and 26 males were followed for a mean of 21.2 ± 23.9 months (range: 1-87 months). Mean age was 65.4 ± 13.6 years old (range: 24-89 years). The mean number of IVB injections per eye was 4.1 ± 3.5 (range: 1-19 injections). <br /> The rate of visual change from baseline to the last follow up was 0.13 log MAR person-year (p= 0.0115). Mean baseline BCVA changed from 1.14 ± 0.6 to mean final BCVA 1.13 ± 0.7 (p=0.6). At presentation, 7.1% (5/70) eyes had a BCVA ≥ 20/40, 34.9%(24/70) eyes had a BCVA between 20/40 and 20/200, and 58.9%(41/70) eyes had a BCVA ≤ 20/200. At the final visit, 14.3% (10/70) eyes had a BCVA ≥ 20/40, 55.7% (39/70) eyes had a BCVA between 20/40 and 20/200, and 30% (21/70) had a BCVA ≤ 20/200. <br /> Mean CMT decreased from 508.2 ± 237.7 µm to 370.9 ± 170.6 µm (p=0.03). <br /> At the last follow-up CME had resolved in 35.7% (25/70) eyes. Of these eyes, 56% (14/25) did not exhibit a change in BCVA, 16% (4/25) lost ≥ 2 lines and 28% (7/25) gained ≥ 2 lines of BCVA. Patients who didn't resolve their CME at the last follow up had a mean BCVA of log MAR 1.17 ± 0.7, and patients who resolved their CME had a mean BCVA of log MAR 1.0 ±0.8 (p= 0.58).<br /> Ocular complications included elevated intraocular pressure in 4 (5.7%) eyes, 1 (1.4%) patient developed POAG and neovascular glaucoma developed in 3 (4.3%) eyes. Two patients passed away during the study period. <br />
Real world experience from a developing country shows that the long term visual outcomes of eyes with macular edema secondary to CRVO treated with prn intravitreal bevacizumab is of visual benefit.
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