Intravitreal Bevacizumab (Avastin(R)) for the Treatment of Macular Edema Secondary to Branch Retinal Vein Occlusion: Results of the Pan-American Collaborative Retina Study Group (PACORES)

Abstract

Purpose:: To report the short-term anatomic and visual outcomes after an intravitreal bevacizumab (Avastin) injection in patients with branch retinal vein occlusion (BRVO).

Methods:: Interventional retrospective multicenter study at 7 centers in 6 countries of 36 eyes of 36 patients with macular edema secondary to BRVO who were treated with at least one intravitreal injection of bevacizumab at a dose of 1.25 mg or 2.5 mg. Patients underwent ETDRS visual acuity (VA) testing, ophthalmoscopic examination, optical coherence tomography (OCT) and fluorescein angiography (FA) at baseline and follow-up visits.

Results:: Thirty six eyes with macular edema secondary to BRVO were injected on average 21 months after the diagnosis (range 3 months to 86 months). The average follow-up is of 29.4 weeks (range from 4 to 52 weeks). The baseline logMAR was 1.00 ± 0.53 (range 0.20 to 2.30). At 1 month the average logMAR was 0.68 ± 0.41 (p=0.0001), at 3 months 0.59 ± 0.43 (p<0.0001), at 6 months 0.53 ± 0.38 (p<0.0001) and at the last follow-up was 0.59 ± 0.42 (p<0.0001). The baseline mean central macular thickness measured by OCT decreased from 439 ± 215 µm to 283 ±126 µm at 1 month (p<0.0001), 248 ± 110 µm at 3 months (p<0.0001), 200 ± 144 µm at 6 months (p<0.0001) and 267 ± 102 µm at the last follow-up (p<0.0001). On average, patients received 1.4 injections per eye (range 1 to 4). Five (14%) eyes required a second injection at a mean of 8 weeks (range from 4 to 13 weeks), four (11.1%) eyes required a third and another (2.8%) required a fourth injection. At the last follow-up, 9 eyes (26%) remained within 3 lines of baseline VA, 27 eyes (74%) improved 3 or more lines of ETDRS VA and none lost more than 3 lines of ETDRS VA. No serious ocular or systemic adverse events were observed.

Conclusions:: Intravitreal bevacizumab at doses up to 2.5 mg may provide stability or improvement in VA and OCT in BRVO. Although the follow-up in our study is short, the results appear promising.

Keywords: vascular occlusion/vascular occlusive disease • retina • macula/fovea