Abstract
Purpose: :
To evaluate the predictive value of age, sex, baseline visual acuity and baseline central retinal thickness in 2.5mg bevacizumab therapy of macular edema (ME) due to branch (BRVO) or central (CRVO) retinal vein occlusion.
Methods: :
After informed consent patients with persistent ME due to retinal vein occlusion received intravitreal bevacizumab (2.5mg/0.1ml). Ophthalmic examination, visual acuity (ETDRS) and Stratus OCTTM were performed at baseline and after 6-8 weeks. Baseline values and patient characteristics were compared between patients with complete resolution of ME 6 weeks after first injection and patients with persistent edema.
Results: :
78 patients (34 CRVO, 44 BRVO) were included in the study. In 43.6% (n=34) of patients (38.2% of CRVO and 61.8% of BRVO) ME completely resolved 6 weeks after 1st injection. Patients with CRVO who showed a complete resolution of ME after first injection had a significantly thinner baseline retinal thickness than CRVO patients with persistent ME (635µm versus 867µm; p=0.0048) and a better baseline visual acuity (0.8 logMAR±0.71 versus 1.04 logMAR±0.54; p=0.056). CRVO patients with complete reduction of ME also were significantly younger (63.5 versus 72.5 years; p=0.012) than patients with persistent ME. 32% of male patients with CRVO had complete resolution of ME after first injection, compared to 47% of female patients with CRVO.In patients with BRVO there was no significant difference in baseline visual acuity, baseline central retinal thickness, age and sex between patients with complete resolution of edema after first injection and patients with persistent edema.
Conclusions: :
In patients with CRVO age, gender, baseline visual acuity and baseline central retinal thickness can help to predict the response to treatment with bevacizumab. In contrast, these factors do not allow to predict treatment outcome in patients with BRVO.Supported by Gertrud Kusen Foundation (Di 2008)
Keywords: vascular endothelial growth factor • edema • macula/fovea