May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
OCT Guided Re-Injection of 2.5mg Bevacizumab for Treatment of Macular Edema Due to Retinal Vein Occlusion
Author Affiliations & Notes
  • A. E. Hoeh
    Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
  • K. B. Schaal
    Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
  • A. Scheuerle
    Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
  • F. Schutt
    Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
  • S. Dithmar
    Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
  • Footnotes
    Commercial Relationships  A.E. Hoeh, None; K.B. Schaal, None; A. Scheuerle, None; F. Schutt, None; S. Dithmar, None.
  • Footnotes
    Support  Gertrud Kusen Foundation (Di2008)
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 3453. doi:https://doi.org/
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      A. E. Hoeh, K. B. Schaal, A. Scheuerle, F. Schutt, S. Dithmar; OCT Guided Re-Injection of 2.5mg Bevacizumab for Treatment of Macular Edema Due to Retinal Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3453. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To evaluate an OCT guided re-injection sceme of 2.5mg bevacizumab in patients with macular edema (ME) due to retinal vein occlusion.

Methods: : Prospective study. After informed consent patients with persistent ME due to branch (BRVO) or central (CRVO) retinal vein occlusion receive intravitreal bevacizumab (2.5mg/0.1ml) every 6 to 8 weeks until ME resolves. Ophthalmic examination, visual acuity (ETDRS) and Stratus OCTTM are performed at baseline and every 6-8 weeks. Re-Injections are only performed if the OCT shows persistent or recurring ME.

Results: : 78 patients (34 CRVO, 44 BRVO) have been included in the study so far with a mean follow-up of 31±21 weeks. In 43.6% (n=34) of patients ME had completely resolved 6 weeks after 1st injection (improvement in visual acuity 3.4±3.8 lines). 57.7% of these patients developed a relapse of ME within 13.3±4.4 weeks after first injection. In 42.3% of patients ME did not recur within 17.3±7.5 weeks. All patients with recurrence of ME received a 2nd injection that completely resolved ME within 6 weeks. Visual acuity gained the same level as after 1st injection (difference in visual acuity: 0.1±2.0 lines). Another relapse of ME in this group occurred in 69.2% of patients 13,1±5,7 weeks (6-25 weeks) after 2nd injection.Patients with persistent ME after 1st injection (56.4%; n=44) received a 2nd injection which led to complete ME resolution in 25%. All of these patients had a recurrence of ME after 13.8±4.1 weeks. In 75% of patients ME persisted after the 2nd injection and they were re-injected. Although no patient showed complete resolution of ME, there was a reduction of central retinal thickness during a follow up of 41.5±17.5 weeks and an average number of injections of 5.1±1.5 (3 to 8 injections). However there was no significant change in visual acuity in these patients.

Conclusions: : OCT guided re-injections lead to anatomic and functional stabilisation or improvement even if transient recurrence of ME occurs and can minimize the number of injections needed in comparison to a re-injection scheme with fixed time intervals.Persistent ME after 1st injection may indicate a poor response to treatment with bevacizumab. Patients with persisting ME after two injections never showed a complete resolution of ME.

Keywords: vascular occlusion/vascular occlusive disease • edema • vascular endothelial growth factor 
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