title: Three treatments for macular edema because of branch retinal vein occlusion: intravitreous bevacizumab or tissue plasminogen activator, and vitrectomy.
abstract: OBJECTIVE
  To evaluate the effectiveness of intravitreous bevacizumab (Avastin), intravitreous tissue plasminogen activator, and vitrectomy for the macular edema secondary to branch retinal vein occlusion.
  
  
  METHODS
  Retrospective, interventional case series. We studied 228 eyes of 228 patients. Forty-one eyes received 1.25 mg of intravitreous bevacizumab, 71 eyes received tissue plasminogen activator, and 116 eyes underwent vitrectomy. A reinjection of 1.25 mg of bevacizumab was based on the morphologic and functional findings. The main outcome measures were the best-corrected visual acuity and optical coherence tomography-determined foveal thickness.
  
  
  RESULTS
  The mean postoperative follow-up period was 32.2 months with a range of 12 months to 69 months. The mean number of intravitreous bevacizumab was 2.8 with a range of 1 to 5. The mean best-corrected visual acuity and foveal thickness significantly improved after all 3 treatments, and the differences in the best-corrected visual acuity between the 3 groups were not significant at 12 months. Fourteen eyes (34%) in the intravitreous bevacizumab group and 21 eyes (30%) in the tissue plasminogen activator group required additional surgeries.
  
  
  CONCLUSIONS
  The 3 treatments appear to provide similar visual outcomes at 12 months. However, in some eyes treated with intravitreous bevacizumab or tissue plasminogen activator, additional surgeries were required, and a longer follow-up period was required to determine the final outcome.
authors.affiliation: Shinjo Ophthalmologic Institute, Mego Shimokitakata-machi, Miyazaki, Japan. kazukuma3313@yahoo.co.jp
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Kumagai
authors.forename: Nobuchika
authors.initials: N
authors.lastname: Ogino
authors.forename: Mariko
authors.initials: M
authors.lastname: Furukawa
authors.forename: Eric
authors.initials: E
authors.lastname: Larson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012170:Retinal Vein Occlusion / Q000150:complications*; D012189:Retrospective Studies; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D005343:Fibrinolytic Agents; D000068258:Bevacizumab; D010959:Tissue Plasminogen Activator