Intravitreal bevacizumab (avastin) in the treatment of macular edema associated with perfused retinal vein occlusion.
OBJECTIVE
To evaluate the efficacy and safety of intravitreal bevacizumab (Avastin) injection in patients with macular edema (ME) secondary to retinal vein occlusive diseases.


METHODS
A prospective, interventional cases series study was conducted in patients with ME secondary to perfused retinal vein occlusions (RVOs), who were treated with intravitreal bevacizumab (2.5 mg per injection in a volume of 0.1 mL). Patients underwent complete ophthalmic evaluation, including Snellen visual acuity, optical coherence tomography (OCT), and fluorescein angiography (FA) at baseline, 1 month, and 3 months after the first injection and at the final visit.


RESULTS
Twenty-five patients (25 eyes) received intravitreal bevacizumab injections. The mean follow-up time was 6.5 months. Mean Snellen visual acuity improved from 20/125 at baseline to 20/74 at 1 month, 20/69 at 3 months, and 20/57 at the last follow-up (P < 0.01). Five of the 25 eyes (20%) had vision gain of >3 lines. The mean central 1 mm macular thickness was 422 microm at baseline and decreased to 263, 333, and 239 microm at 1 month, 3 months, and the last follow-up, respectively. Recurrent macular edema with a rebound increase of central retinal thickness was observed 3 months after the first injection, and improved after repeated bevacizumab injections. Patients received an average of 2 injections (range 1-3). FA showed no evidence of increased nonperfusion avascular area. No adverse ocular or systemic events were observed following injections.


CONCLUSIONS
The observed anatomic and visual acuity improvements after intravitreal bevacizumab injection demonstrate that bevacizumab is a useful adjunctive treatment for ME secondary to RVO without safety concerns in a short term. However, repeated injections are needed to maintain visual improvement. Long-term study is warranted to assess the long-term efficacy and safety.
Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
Kuo-Hsuan
KH
Hung
Shui-Mei
SM
Lee
Shih-Yun
SY
Lee
Feng-Lih
FL
Lee
Chang-Sue
CS
Yang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D056965:Injections, Intraocular; D008266:Macula Lutea / Q000473:pathology; D008269:Macular Edema / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012170:Retinal Vein Occlusion / Q000150:complications*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000187:drug effects; D014822:Vitreous Body
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab