Bevacizumab for CRVO Associated CME: Effect of Timing and Frequency of Injections on Final Visual Outcome.
Purpose. Injection of anti-VEGF antibody into the vitreous body is a well-established treatment for ischemic central retinal vein occlusion (CRVO) associated macular edema. Various treatment regimens regarding the timing, number, and frequency of injections have been proposed. Methods. We reviewed the medical records of 68 patients treated by intravitreal bevacizumab (Avastin) injections for macular edema due to CRVO. We examined final visual acuity six months following the last injection in relation to injection policy (one primary injection followed by subsequent injections based on anatomical response versus a prescheduled protocol of one injection per month for the first 3 months) and in relation to the time lapsing from CRVO diagnosis to the first injection. Results. Mean visual acuity improved more for patients treated by a protocol of 3 prescheduled injections than for those treated with one primary injection. Improvement in mean visual acuity was greater for patients who received their first injection within the first month than those treated after 3 months (P < 0.01). Conclusion. A protocol of three prescheduled injections of bevacizumab, starting within one month of a CRVO event, was associated with better visual outcome compared to single injection and/or treatment starting more than 3 months following the time of diagnosis.
Department of Ophthalmology, Ziv Medical Center, Safed, Israel ; Faculty of Medicine, Bar Ilan University, Safed, Israel.
Joseph
J
Pikkel
Department of Ophthalmology, Ziv Medical Center, Safed, Israel.
Otzem
O
Chassid
Department of Ophthalmology, Ziv Medical Center, Safed, Israel.
Yumna
Y
Busool
Department of Ophthalmology, Ziv Medical Center, Safed, Israel.
Ward
W
Srour
Research Wing, Ziv Medical Center, Safed, Israel and Tel-Hai Academic College, Israel.
Adi
A
Sharabi-Nov
Department of Ophthalmology, Rambam Medical Center, Haifa, Israel ; The B. Rappaport Faculty of Medicine, Technion, Haifa, Israel.
Itzchak
I
Beiran