Bevacizumab in the treatment of macular edema complicating retinal vein occlusions

Abstract

Purpose : Retinal vein occlusions (RVO) are the second most common cause of visual impairment due to retinal vascular disorders, mainly as the consequence of macular edema. We evaluated changes in visual acuity and macular thickness at 18 months after intravitreal bevacizumab for the treatment of macular edema in patients with RVO.

Methods : Of 45 consecutive patients with macular edema complicating RVO and treated with intravitreal injections of bevacizumab 1.25 mg/0.05 ml, 39 were followed for 18 months after the initial injection. Snellen visual acuity expressed in LogMar units and macular thickness measured in microns by spectral domain optical coherence tomography (SD-OCT) were the outcome measures. At baseline RVO was classified into branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO), and in non-ischemic and ischemic, according to clinical and fluorescein angiography presentation. All patients were evaluated, treated and followed by the same physician. Wilcoxon test for paired variables, Mann Whitney for independent variables, and Student test for continuous variables, were used for statistical analysis.

Results : Mean age was 66.8 years (SD: 13.65), 57% men and 43% women; 62.5% of cases were CRVO and 37.5% BRVO. Mean number of injections was 4.11±1.61 (range= 1-6). Photocoagulation was performed in 25% of patients not responding to bevacizumab. At 18 months of follow-up, improvement of visual acuity (p=0.0001) and macular thickness (p=0.0009) from baseline was observed. Best visual results were obtained at first month (median= 1.00 P25= 0.5 P75= 1.30) and at 9 month (median= 0.8 P25= 0.5 P75= 1.20) after first injection, but no further improvement was observed beyond 9 months of treatment (p=0.84). No significant visual and macular thickness differences were obtained between patients treated with bevacizumab alone (p=0.116) and bevacizumab and laser (p=0.846). No ocular or systemic side effects attributable to treatment were observed.

Conclusions : Bevacizumab was safe and effective in improving visual acuity and reducing macular thickness in this series of patients with macular edema complicating RVO.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.