Visual Acuity Following the Treatment of Macular Edema Associated With CRVO: Intravitreal Bevacizumab Compared With Triamcinolone Acetonide

Abstract

Purpose: : To compare intravitreal Bevacizumab with Triamcinolone Acetonide (IVTA) as a treatment modality for macular edema associated with central retinal vein occlusion (CRVO).

Methods: : Retrospective chart review was conducted for consecutive patients who received intravitreal Bevacizumab (n=6) or IVTA (n=12) to treat macular edema associated with CRVO. Visual acuity (logMAR) was compared at preinjection, 1-month, 3-month, 6-month and 12-month marks. Central foveal thickness (CFT) was evaluated with optical coherence tomography (OCT).

Results: : Follow up for the Bevacizumab group ranged from 0 to 24 months with a mean of 14 months. Follow up for the IVTA group ranged from 0 to 44 months with a mean of 16 months. Patients in the Bevacizumab group received a mean of 2 injections (range 1 to 4). People in the IVTA group received a mean of 1 injection (range 1 to 2). Mean time from diagnosis to injection was 82 days for the Bevacizumab group, and 46 days for the IVTA group. An initial trend towards improvement in visual acuity was seen in the Bevacizumab group compared with the IVTA group at the 3-month mark (logmar Va 0.55 and 1.3 respectively), but this effect was not seen at the 12-month mark. Consistent OCT data was available only for the Bevacizumab group, with a mean pre-injection CFT of 615 microns and 3-month CFT of 316 microns. No adverse events were noted in the Bevacizumab group. One person in the IVTA group developed a cataract. Another person in the IVTA group developed high intraocular pressure, requiring medical management.

Conclusions: : There may be a short-term improvement in visual acuity in patients receiving Bevacizumab for the treatment of macular edema related to CRVO.

Keywords: edema • macula/fovea • vascular occlusion/vascular occlusive disease