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N. Z. Gregori, P. J. Rosenfeld, C. A. Puliafito, A. M. Berrocal, L. Al-Attar, H. W. Flynn, Jr., W. E. Smiddy, S. Dubovy, S. G. Schwartz, W. Feuer; Intravitreal Bevacizumab (Avastin®) for Macular Edema Secondary to Branch and Hemiretinal Vein Occlusions. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1546.
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To evaluate safety and efficacy of intravitreal bevacizumab (Avastin®, Genentech) for the treatment of macular edema (ME) secondary to branch and hemiretinal vein occlusions (BRVO and HRVO).
A retrospective review was performed of eyes treated with intravitreal bevacizumab for ME secondary to BRVO and HRVO at the Bascom Palmer Eye Institute from June 2005 to June 2006. All patients underwent Snellen visual acuity (VA) assessment and OCT imaging with 1 mm central retinal thickness (CRT) measurements as part of their routine clinical care. The dose of bevacizumab was 1.25 mg (0.05 ml). Retreatment was performed at monthly or longer intervals at the discretion of the treating physician.
Thirty (73%) eyes with BRVO and 11 (27%) eyes with HRVO were identified, for a total of 41 eyes of 39 patients. Thirty eight (93%) eyes were seen at 1-month follow-up, 35 (85%) at 3 months, and 25 (61%) at 6 months. Mean VA was 39 letters at baseline, 52 at 1 month, 53 at 3 months, and 50 at 6 months. Eyes gained a mean of 11 letters at 1 month (p<0.001), 13 letters at 3 months (p<0.001), and 11 letters at 6 months (p=0.003). VA increased by at least 3 lines in 47% at 1 month, 51% at 3 months, and 36% at 6 months. The mean CRT was 461 µm at baseline, 296 µm at 1 month (p<0.001, n=35), 347 µm at 3 months (p=0.003, n=34), and 330 µm at 6 months (p=0.003, n=21). VA loss of ≥3 lines occurred in 3% at 1 month, 6% at 3 months, and 4% at 6 months. Thirty three (91%) eyes received >1 injection by 6 months of follow-up. There were no cases of uveitis, endophthalmitis, retinal detachment, or systemic complications.
Significant improvements in VA and CRT measurements were observed following intravitreal bevacizumab in patients with BRVO and HRVO through 6 months. No systemic or ocular complications were noted. These retrospective results support efforts to prospectively investigate intravitreal bevacizumab for the treatment of macular edema in retinal vein occlusions.
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