Visual improvement in central retinal vein occlusion (CRVO) following intravitreal injections of bevacizumab (Avastin(®) ).
OBJECTIVE
To perform a prospective study on central retinal vein occlusion (CRVO) to evaluate whether visual acuity can be improved and macular oedema reduced in response to intravitreal injections of bevacizumab.


METHODS
The case material comprised 13 patients (aged 34-79 years), duration of CRVO was 2 weeks to 6 months, baseline ETDRS visual acuity 0.06-0.4 (mean Snellen 0.13, derived from logMAR value) and intraocular pressure (IOP) 12-20 (mean 15.2) mmHg. Clinical examination, including optical coherence tomography (OCT), was carried out at baseline and every 6 weeks, digital fluorescein angiography at baseline, at 3 months and 6 months. Intravitreal injections of bevacizumab (1.25 mg) were given under microscopic control at baseline and every 6 weeks during the 6-month follow-up.


RESULTS
Following one intravitreal injection of bevacizumab, average visual acuity improved by 13 ETDRS letters at 1 month (p < 0.05) and in response to 4 injections by 24 letters (logMAR 0.48) at 6 months (p < 0.05). Foveal thickness as measured by OCT decreased from 596 μm at baseline to 288 μm at 6 months (p < 0.05) concomitant with resorption of intra- and subretinal fluid. IOP ranged from 10 to 24 (17.3) mmHg at 6-month follow-up. No adverse events occurred.


CONCLUSIONS
In response to four intravitreal injections of bevacizumab during 6 months, a substantial improvement in visual acuity and reduction in central retinal thickness were achieved. A randomized clinical trial is warranted to further evaluate the efficacy and safety of this treatment modality.
Algvere
Peep V
PV
Karolinska Institutet, St. Eriks Eye Hospital, Stockholm, Sweden. peep.algvere@sankterik.se
Von Wendt
Gunvor
G
Gudmundsson
Johann
J
Seregard
Stefan
S
Kvanta
Anders
A
D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D058449:Intravitreal Injections; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012160:Retina / Q000473:pathology; D012170:Retinal Vein Occlusion / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000502:physiology*
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab