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V. Daien, C. Schneider, S. Navarre, D. Audemard, I. Aubry, P. Fesler, M. Villain; Early Intravitreal Bevacizumab for Central Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2803.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effect of 3 intravitreal bevacizumab (Avastin, Genentech) injections on visual acuity and foveal retinal thickness at early stage of central retinal vein occlusion (CRVO) at 6 months after the beginning of treatment.
This prospective, noncomparative, consecutive, interventional case series included 14 patients (14 eyes) with a recent central retinal vein occlusion (less than 3 months) associated with macular edema and initial visual acuity worse than 20/40. Early Treatment Diabetic Retinopathy Study Best-Corrected Visual Acuity (BCVA), ophthalmic examination, and Optical Coherence Tomography (OCT) were performed at baseline and during every follow-up visits. All patients received 3 intravitreal injections of bevacizumab (1.25 mg) each separated by 4 weeks between the injections. Study endpoints were BVCA and central macular edema 3 months after the last injection.
Results (mean +/- sd, median +/- range) : Mean age was 65 +/-11 and median duration of symptoms before the first injection was 30 days (20-60 days). Mean visual acuity improved significantly from 0,78 +/-0,42 logMAR at baseline to 0,61 +/-0,55 logMAR (P = 0.05) at the last visit. For the group of subject with initial visual acuity betwen 20/50 to 20/200 54,5 % improved, 36,4% stayed at the same level and 9,1 % got worse. When initial visual acuity was worse than 20/200, the prognosis for vision was poor, 67 % remained at this level and 33 % improved. Mean central retinal thickness decreased significantly from 563 +/- 200 µm at baseline to 328+/- 134 µm (P < 0.002) during the last visit (3 months after last injection).
Intravitreal bevacizumab injections given in the first 3 months after onset of central retinal vein occlusion may result in a significant increase in vision and a concomitant decrease in macular oedema. We did not observe any short-term adverse effects during our study. A prospective randomized and controlled trial with a longer follow up is necessary to confirm these results.
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