Visual improvement in central retinal vein occlusion (CRVO) following intravitreal injections of bevacizumab (Avastin(®) )

PURPOSE: To perform a prospective study on central retinal vein occlusion (CRVO) to evaluate whether visual acuity can be improved and macular oedema reduced in response to intravitreal injections of bevacizumab.

METHODS: The case material comprised 13 patients (aged 34-79 years), duration of CRVO was 2 weeks to 6 months, baseline ETDRS visual acuity 0.06-0.4 (mean Snellen 0.13, derived from logMAR value) and intraocular pressure (IOP) 12-20 (mean 15.2) mmHg. Clinical examination, including optical coherence tomography (OCT), was carried out at baseline and every 6 weeks, digital fluorescein angiography at baseline, at 3 months and 6 months. Intravitreal injections of bevacizumab (1.25 mg) were given under microscopic control at baseline and every 6 weeks during the 6-month follow-up.

RESULTS: Following one intravitreal injection of bevacizumab, average visual acuity improved by 13 ETDRS letters at 1 month (p < 0.05) and in response to 4 injections by 24 letters (logMAR 0.48) at 6 months (p < 0.05). Foveal thickness as measured by OCT decreased from 596 μm at baseline to 288 μm at 6 months (p < 0.05) concomitant with resorption of intra- and subretinal fluid. IOP ranged from 10 to 24 (17.3) mmHg at 6-month follow-up. No adverse events occurred.

CONCLUSIONS:   In response to four intravitreal injections of bevacizumab during 6 months, a substantial improvement in visual acuity and reduction in central retinal thickness were achieved. A randomized clinical trial is warranted to further evaluate the efficacy and safety of this treatment modality.