title: Rebound of macular edema after intravitreal bevacizumab therapy in eyes with macular edema secondary to branch retinal vein occlusion.
abstract: OBJECTIVE
  To determine the incidence of rebound macular edema after intravitreal bevacizumab in eyes with macular edema secondary to branch retinal vein occlusion and to identify the pretreatment factors that were significantly associated with the rebound.
  
  
  METHODS
  The changes in the foveal thickness after the intravitreal bevacizumab (1.25 mg/0.05 mL) were studied in 65 eyes of 65 patients with macular edema secondary to branch retinal vein occlusion. A rebound of macular edema was defined as a ≥110% increase in the foveal thickness or a foveal thickness ratio of ≥110% (foveal thickness at the recurrence/foveal thickness at the baseline × 100). Multivariate logistic regression analyses and subgroup analyses were performed to determine which pretreatment factors were associated with the rebound.
  
  
  RESULTS
  Seven of 65 eyes (10.8%) showed a rebound (≥110% of baseline thickness). Subgroup analyses showed that a thinner pretreatment fovea and a shorter interval between symptom onset to the initiation of the intravitreal bevacizumab were significantly associated with a rebound of macular edema (P < 0.01). The interval from symptoms onset to the initiation of treatment was <8 weeks in all 7 eyes with a rebound macular edema.
  
  
  CONCLUSIONS
  These results suggest that a rebound of macular edema in eyes with branch retinal vein occlusion was more likely to occur when the intravitreal bevacizumab therapy is initiated before the macular edema reaches the maximum level. Rebound of macular edema may be effectively avoided by waiting at least 8 weeks after the onset of symptoms to begin the intravitreal bevacizumab.
authors.affiliation: Department of Ophthalmology, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Yasuda
authors.forename: Mineo
authors.initials: M
authors.lastname: Kondo
authors.forename: Shu
authors.initials: S
authors.lastname: Kachi
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Ito
authors.forename: Takayuki
authors.initials: T
authors.lastname: Terui
authors.forename: Shinji
authors.initials: S
authors.lastname: Ueno
authors.forename: Hiroko
authors.initials: H
authors.lastname: Terasaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D005260:Female; D005584:Fovea Centralis / Q000473:pathology; D006801:Humans; D015994:Incidence; D058449:Intravitreal Injections; D008269:Macular Edema / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012170:Retinal Vein Occlusion / Q000150:complications*; D012307:Risk Factors; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab