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M. Ali Khan, Arman Mashayekhi, Kyle Ferguson, Jerry A Shields, Carol L Shields; High dose (2.5 mg) intravitreal bevacizumab as rescue therapy for persistent post-radiation cystoid macular edema. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4099.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the efficacy of intravitreal high dose (2.5 mg) bevacizumab as rescue therapy for post-radiation cystoid macular edema (CME) resistant to standard dose (1.25 mg) bevacizumab.
Retrospective, interventional case series at Wills Eye Hospital (Philadelphia, PA).
Fifteen eyes of 15 patients were included. All eyes were treated with a mean of 10 standard-dose (1.25 mg) bevacizumab injections but failed to show complete CME resolution. Following 3 monthly treatments of high dose (2.5 mg) bevacizumab, mean CMT reduced significantly from 406±100 to 360±83 microns (p = 0.013) and mean VA improved from 0.55±0.17 (Snellen 20/71) to 0.48±0.21 (Snellen 20/60, p = 0.07). At mean final follow-up of 9 months, CMT was 395±124 (p=0.67) and VA was 0.51±0.23 (Snellen 20/65, p=0.22) following a mean of 7.5 high dose (2.5 mg) bevacizumab treatments. Five eyes (30%) had a >10% reduction in CMT at final follow-up. In these eyes, the observed reduction in CMT was statistically significant (p=0.04) and logMAR visual acuity was significantly better (p=<0.01) compared to the remainder of the cohort.
High dose (2.5 mg) intravitreal bevacizumab resulted in a significant improvement in CMT and VA outcomes in a subset of eyes (5/15, 30%) following incomplete response to standard dose (1.25 mg) bevacizumab. Our results indicate more work is necessary to explore rescue therapies in this patient population.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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