Intravitreal Bevacizumab (Avastin) for the Management of Refractory Pseudophakic Cystoid Macular Edema: 6 Month Results of the Pan American Collaborative Retina Study (PACORES) Group

Abstract

Purpose: : To determine the feasibility, safety and clinical effect of intravitreal (IVT) bevacizumab (Avastin) in patients with refractory cystoid macular edema (CME) after cataract surgery.

Methods: : Thirty-six eyes of 31 patients with a mean age of 69.5 years (range: 50 to 87 years) that were treated with at least one IVT injection of 1.25 mg or 2.5 mg of bevacizumab participated in this interventional retrospective multicenter study. Patients had a mean follow-up of 42.3 weeks (range: 24 to 80 weeks).

Results: : Twenty-five eyes (69.4%) demonstrated improvement of best-corrected visual acuity (BCVA) (≥2 ETDRS lines) and no eye experienced worsening of visual acuity (≥2 ETDRS lines). Mean baseline BCVA was 20/160 (logMAR = 0.92) and the mean final BCVA was 20/63 (logMAR = 0.55) (p < 0.0001). Optical coherence tomography (OCT) demonstrated that mean central macular thickness at baseline was 456.2 µm (range: 208 to 784 µm) and decreased to a mean of 262.9µm (range: 142 to 453 µm) at the end of follow-up (p < 0.0001). Twenty (55.5%) eyes needed a second injection, nine (25%) needed a third injection, and five (13.9%) needed a fourth injection. The mean interval between injections was 17.6 weeks (range: 6 to 45 weeks). No ocular or systemic adverse events were observed.

Conclusions: : Short-term results suggest that IVT bevacizumab is well tolerated in patients with refractory pseudophakic CME. Treated eyes had a significant improvement in BCVA and decrease in macular thickness by OCT.

Keywords: macula/fovea • edema • retina