title: Clinical, anatomical, and electrophysiological assessments of the central retina following intravitreal bevacizumab for macular edema secondary to retinal vein occlusion.
abstract: The purpose of this study is to evaluate the long-term visual, anatomical and electrophysiological outcomes of repeated intravitreal injections of bevacizumab for macular edema due to retinal vein occlusion (RVO) and investigate any possible toxic effects on the central fovea. This is a prospective, noncomparative, interventional case series. Thirty-three eyes of 33 patients with macular edema secondary to RVO were treated with 1.25 mg/0.05 ml intravitreal bevacizumab. Nine patients had nonischemic central retinal vein occlusion (CRVO) and 24 patients had branch retinal vein occlusion (BRVO). The main outcome measures were best-corrected visual acuity, central retinal thickness (CRT), and multifocal electroretinography (mfERG) responses changes at baseline, 1 month after the third injection and at the end of the 2-year long follow-up period. Patients with CRVO had mean best-corrected Snellen visual acuity of 0.10 at baseline, which improved significantly to 0.31 after 2 years (P = 0. 028).The mean CRT at presentation was 756.28 μm and reduced significantly to 439.14 μm after 2 years (P = 0.05). Patients with BRVO had mean best-corrected Snellen visual acuity of 0.19 at baseline, which improved significantly to 0.40 after 2 years (P < 0.001). The mean CRT at presentation was 681.04 μm and reduced significantly to 369.81 μm after 2 years (P < 0.001). Mean mfERG responses within central 10° (ring1, ring2) showed statistically significant differences on P1 parameters in terms of response density and implicit time after 2 years in both CRVO and BRVO patients. Repeated intravitreal bevacizumab injections for macular edema due to either CRVO or BRVO resulted in long-term improvement of visual acuity, a reduction in CRT and statistically significant changes in the mfERG responses with nondemonstrable toxic effects on the central fovea.
authors.affiliation: Department of Ophthalmology, University of Athens, Athens, Greece. eleniloukianou@yahoo.com.|, 100 Petrou Tsirou st., 3076, Limassol, Cyprus. eleniloukianou@yahoo.com.
authors.forename: Eleni
authors.initials: E
authors.lastname: Loukianou
authors.affiliation: Department of Ophthalmology, University of Athens, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Brouzas
authors.affiliation: Department of Ophthalmology, University of Athens, Athens, Greece.
authors.forename: Klio
authors.initials: K
authors.lastname: Chatzistefanou
authors.affiliation: Department of Ophthalmology, University of Athens, Athens, Greece.
authors.forename: Chrysanthi
authors.initials: C
authors.lastname: Koutsandrea
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000068258:Bevacizumab / Q000008:administration & dosage*; D004596:Electroretinography; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012160:Retina / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D012170:Retinal Vein Occlusion / Q000150:complications*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab
keywords: Bevacizumab; Macular edema; Multifocal electroretinography; Optical coherence tomography; Retinal vein occlusion
references.citation: Ophthalmology. 2010 Jun;117(6):1113-1123.e15
references.pmid: 20430446
references.citation: Doc Ophthalmol. 2012 Feb;124(1):1-13
references.pmid: 22038576
references.citation: Retina. 2007 Apr-May;27(4):419-25
references.pmid: 17420692
references.citation: Mol Ther. 2008 Apr;16(4):791-9
references.pmid: 18362932
references.citation: Ophthalmology. 2010 Jun;117(6):1134-1146.e3
references.pmid: 20417567
references.citation: Retina. 2007 Oct;27(8):1013-9
references.pmid: 18040237
references.citation: Retina. 2006 Mar;26(3):270-4
references.pmid: 16508425
references.citation: Arch Ophthalmol. 1989 Jul;107(7):998-1000
references.pmid: 2751472
references.citation: Ophthalmology. 1995 Oct;102(10):1425-33
references.pmid: 9097788
references.citation: Br J Ophthalmol. 2008 Apr;92(4):518-22
references.pmid: 18211942
references.citation: Doc Ophthalmol. 2013 Apr;126(2):137-48
references.pmid: 23255086
references.citation: Korean J Ophthalmol. 2011 Jun;25(3):161-5
references.pmid: 21655040
references.citation: Ophthalmology. 1993 Mar;100(3):423-8
references.pmid: 8460014
references.citation: Arch Ophthalmol. 1986 Jan;104(1):34-41
references.pmid: 2417579
references.citation: Expert Opin Biol Ther. 2005 Jul;5(7):997-1005
references.pmid: 16018743
references.citation: Doc Ophthalmol. 2007 Jan;114(1):37-44
references.pmid: 17216267
references.citation: Ophthalmology. 1996 Apr;103(4):551-60
references.pmid: 8618752
references.citation: Arch Ophthalmol. 1997 Apr;115(4):486-91
references.pmid: 9109757
references.citation: Arch Ophthalmol. 1982 Jul;100(7):1132-40
references.pmid: 6178389
references.citation: Retina. 2010 Jul-Aug;30(7):1025-33
references.pmid: 20616681
references.citation: Ophthalmology. 1995 Oct;102(10):1434-44
references.pmid: 9097789
references.citation: Arch Ophthalmol. 2002 Dec;120(12 ):1644-50
references.pmid: 12470137
references.citation: Graefes Arch Clin Exp Ophthalmol. 2005 Jan;243(1):3-8
references.pmid: 15258777
references.citation: Am J Ophthalmol. 2007 Apr;143(4):601-6
references.pmid: 17306753
references.citation: Doc Ophthalmol. 2008 Mar;116(2):129-35
references.pmid: 17960440
references.citation: Am J Ophthalmol. 1984 Sep 15;98(3):271-82
references.pmid: 6383055
references.citation: Retina. 2012 May;32(5):972-6
references.pmid: 22105506
references.citation: Ophthalmology. 1999 Nov;106(11):2054-62
references.pmid: 10571337
references.citation: Retina. 2009 Mar;29(3):306-12
references.pmid: 19060776
references.citation: Retina. 2008 Oct;28(9):1325-37
references.pmid: 19430392
references.citation: Retina. 2011 Oct;31(9):1856-62
references.pmid: 21659943
references.citation: Ophthalmology. 2010 Feb;117(2):313-9.e1
references.pmid: 20022117
references.citation: Am J Ophthalmol. 2010 Jan;149(1):147-54
references.pmid: 19875087
references.citation: Retina. 2006 Oct;26(8):889-95
references.pmid: 17031288