Changes in Retinal Nonperfusion Area Before and After Intravitreal Injection of Bevacizumab in Eyes With Macular Edema Secondary to Branch Retinal Vein Occlusion

Abstract

Purpose: : To study the effect of an intravitreal injection of bevacizumab, an anti-vascular endothelial growth factor (VEGF) antibody, on the area of retinal ischemia in eyes with macular edema secondary to branch retinal vein occlusion (BRVO).

Methods: : Fluorescein angiography (FA) was performed before and one month after an intravitreal injection of 1.25 mg / 0.05 ml bevacizumab in 45 consecutive eyes of 45 patients with macular edema secondary to BRVO. The nonperfusion area (NPA) was measured on an early phase FA image at the center of the macula by the IMAGEnet system (Topcon). The size was expressed as the size of the optic disc area (DA). A blockage of the fluorescence by a retinal hemorrhage was distinguished from a NPA by comparisons with retinal photographs.

Results: : Thirty-one of 45 eyes did not have a NPA before treatment, and NPAs developed in 3 of these 31 eyes one month after the injection. The NPA in these three eyes were 0.47 DA, 0.12 DA, and 0.05 DA. Fourteen of the 45 eyes had NPAs before treatment, and the mean (± SD) NPA before injection was 2.49 ± 4.41 DA which increased to 3.19 ± 5.80 DA one month after the injection. This difference was not significant (P=0.31). An increase in the NPA > 1.0 DA was seen in only two of the 45 eyes.

Conclusions: : These results suggest that the incidence of a significant increase of the NPA after an intravitreal injection of bevacizumab is very low in eyes with a BRVO.

Keywords: vascular endothelial growth factor • ischemia • macula/fovea