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F. C. DeCroos, J. P. Ehlers, S. Stinnett, S. Fekrat; Treatment of Cystoid Macular Edema in Eyes With Retinal Vein Occlusion Using Intravitreal Bevacizumab. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3575.
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© ARVO (1962-2015); The Authors (2016-present)
Cystoid macular edema (CME) is a frequent cause of vision loss in eyes with retinal vein occlusion (RVO). This study investigates visual and anatomical outcomes in these eyes after treatment with intravitreal bevacizumab (IVB).
Retrospective review was performed in 101 consecutive eyes with RVO treated with IVB. Exclusion criteria include ocular laser or steroid therapy within 4 months of IVB. Data collected included perfusion status, best corrected visual acuity (BCVA), central foveal thickness (CFT) on optical coherence tomography (OCT), and complications. Central retinal vein occlusion (CRVO) eyes and branch retinal vein occlusion (BRVO) eyes were analyzed separately. Eyes with hemiretinal vein occlusion (HRVO) were included in the BRVO group.
The BRVO group included 53 patients. Fourteen eyes underwent steroid and/or laser therapy prior to IVB. The mean time from BRVO onset till first IVB was 16 months. The mean initial BCVA was 20/137 compared to 20/96 (p = 0.05) at final follow up. Gains of > 3 lines of visual acuity were seen in 24% and 28% at 6 months and final follow-up, respectively. Less than 3 line loss was seen in > 95% at 6 months and final follow-up. Initial mean CFT was 425 compared to 289 microns (p < 0.001) at final follow up. Mean follow-up was 8.7 months. Mean number of injections was 2.5.The CRVO group included 48 patients. Five eyes underwent steroid and/or laser therapy prior to IVB. The mean time from CRVO onset till first IVB was 8 months. The mean initial BCVA was 20/288 compared to 20/204 (p=0.03) at final follow up. At 6 months and final follow-up, > 3 line gain in visual acuity was seen in 62% and 54%, respectively. Less than 3 line loss was seen in 83% at final follow-up. Initial mean CFT was 591 compared to 392 microns at final follow up (p<0.001). Mean follow-up was 10.5 months. Mean number of injections was 3.6. There were no systemic or ocular complications in either subgroup.
IVB improves foveal thickness in eyes with RVO, but this does not always correlate with visual recovery. Some eyes experience marked improvement in visual acuity. Further study is needed to elucidate the role of IVB as monotherapy, as well as IVB as one modality of a multi-treatment regimen.
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