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A. Lux, K. K. Huber, H. Llacer, C. Scholz, Y. Talou, A. M. Joussen; Changes in Microperimetry After Intravitreal Bevacizumab in Patients With Non-Ischemic Macular Edema Due to Vein Occlusion. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4715. doi: https://doi.org/.
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A potential benefit of intravitreal bevacizumab to reduce macular oedema due to vein occlusion has already been described. Though, the two habitual follow-up methods, OCT and visual acuity (VA) testing, often show contradictory results. While, in some cases, the patient reports a subjective improvement and an objective reduction of retinal thickness is confirmed, the VA lacks to improve. Therefore, the sensivity of microperimetry as possible additional test in the follow-up of patients receiving intravitreal bevacizumab for non-ischemic macular oedema due to vein occlusion was evaluated.
Four patients (more patients in analysis) primary treated with intravitreal bevacizumab for non-ischemic macular edema due to central or branch vein occlusion underwent microperimetry. Furthermore testing of ETDRS visual acuity, reading ability, OCT and fluorescein angiography prior and every 6 weeks after treatment were performed. No preceding panretinal or focal laser coagulation was allowed.
In two patients improving from intravitreal bevacizumab the results of microperimetry, OCT and VA testing were concurrent. The microperimetry improved by 10 and 8dB, the macular oedema was reduced by 490 and 322µm while VA improved by 3 and 4 lines, respectively. A subjectively reported improvement of one patient after injection could not be observed by VA or OCT testing but was confirmed in the microperimetry showing an improvement from 0-2dB to up to 14dB (possible max: 20dB). One patient did not improve after injection showing no change in VA, reading ability, OCT or microperimetry.
This preliminary data suggest that microperimetry could be a reasonable additional test in the follow-up of patients receiving intravitreal bevacizumab for non-ischemic macular edema due to vein occlusion. While VA testing can give an indication of the foveal function, microperimetry assessment may include the function of any point chosen within the macula or extrafoveal. Further patient analysis and long term follow-up examinations will have to follow.
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