Abstract
Purpose: :
To report the anatomical results and visual acuity response after intravitreal injection of bevacizumab (Avastin, Genentech) in patients with macular edema due to central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO).
Methods: :
Retrospective study of 48 eyes with macular edema due to CRVO or BRVO were treated at least with one intravitreal injection of bevacizumab. Patients underwent Snellen visual acuity testing, optical coherence tomography, fluorescein angiography and ophtalmologic examination at baseline and on follow-up visits.
Results: :
48 eyes of 47 patients were included. Patients received a mean of 2.18 injections of bevacizumab per eye. No adverse effects were observed like endophtalmitis, intraocular inflammation, lens touch, ocular hypertension, retinal detachment or thrombembolic events. Mean macular retinal thickness was 497 microns and decreased in follow up to 379 microns (p=0,004). The mean baseline visual acuity was 20/125 (logMAR -0,84) and increased to 20/100 (logMAR -0,66, p=0,003). Visual acuity improvement was observed in 28 patients (58,3%), 15 patients of them gained more than 3 lines (31,25%). Visual acuity was stable in 13 patients (27%). 7 patients got worse (14,7%), 3 patients of them lost more than 3 lines (6,25%). 85% of patients with visual acuity loss had an ischemic retinal vein occlusion. Ischemic retinal vein occlusion was associated with significantly lower visual acuity gain than non ischemic retinal vein occlusion (p=0,024). 5 patients converted in an ischemic retinal vein occlusion after bevacizumab injection.
Conclusions: :
Intravitreal bevacizumab resulted in a decrease of macular edema and improvement of visual acuity. Nevertheless often several injections are needed to reduce or stabilize macular retinal thickness.
Keywords: retina • macula/fovea • vitreous