Intravitreal Injection of Bevacizumab for Macular Edema Secondary to Branch Retinal Vein Occlusion

Abstract

Purpose: : To report visual acuity change and central retinal thickness (CRT) variation after intravitreal injections of bevacizumab (IVB) in patients with macular edema (ME) secondary to branch retinal vein occlusion (BRVO).

Methods: : 18 eyes of 18 patients with ME secondary to BRVO were retrospectively reviewed. Mean disease duration was 14.3 months. Four patients were refractory to previous laser treatment or intravitreal injection of triamcinolone acetonide, 14 had not received previous treatments. All patients underwent a complete examination including ETDRS visual acuity measurement, fluorescein angiography and OCT. The patients received 3 monthly consecutive IVB, followed by repeated injections, laser treatment or no treatment on the basis of OCT parameters and angiographic patterns over the 12-month follow-up.

Results: : Mean best corrected visual acuity (BCVA) was 0.94 ± 0.49 LogMar at baseline, 0.84 ± 0.45 logMar at three-month follow-up and 0.7 ± 0.42 LogMar at 1 year follow up. CRT was 536 ± 194 µm at baseline, 436 ± 167 µm at three-month follow-up and 471 ± 175 LogMar at 1 year follow up. No complications related neither to injection procedure nor to drug occurred. Seven eyes did not receive any further treatment, 4 eyes were treated with laser photocoagulation, 6 eyes were reinjected with bevacizumab (1 eye had one reinjection, 3 eyes three reinjections, 2 eyes six reinjections), 1 eye received one reinjection and laser treatment.

Conclusions: : IVB alone or associated with laser photocoagulation is effective in improving BCVA and CRT in patients with ME secondary to BRVO over a12-month follow-up. The use of IVB in ME secondary to BRVO is promising. However, further studies are needed to assess the best treatment regimen and real efficacy.

Keywords: vascular occlusion/vascular occlusive disease • edema • injection