Intravitreal bevacizumab (avastin) in the treatment of macular edema associated with perfused retinal vein occlusion

Kuo-Hsuan Hung, Shui-Mei Lee, Shih-Yun Lee, Feng-Lih Lee, Chang-Sue Yang
Journal of Ocular Pharmacology and Therapeutics 2010, 26 (1): 85-90

PURPOSE: To evaluate the efficacy and safety of intravitreal bevacizumab (Avastin) injection in patients with macular edema (ME) secondary to retinal vein occlusive diseases.

METHODS: A prospective, interventional cases series study was conducted in patients with ME secondary to perfused retinal vein occlusions (RVOs), who were treated with intravitreal bevacizumab (2.5 mg per injection in a volume of 0.1 mL). Patients underwent complete ophthalmic evaluation, including Snellen visual acuity, optical coherence tomography (OCT), and fluorescein angiography (FA) at baseline, 1 month, and 3 months after the first injection and at the final visit.

RESULTS: Twenty-five patients (25 eyes) received intravitreal bevacizumab injections. The mean follow-up time was 6.5 months. Mean Snellen visual acuity improved from 20/125 at baseline to 20/74 at 1 month, 20/69 at 3 months, and 20/57 at the last follow-up (P < 0.01). Five of the 25 eyes (20%) had vision gain of >3 lines. The mean central 1 mm macular thickness was 422 microm at baseline and decreased to 263, 333, and 239 microm at 1 month, 3 months, and the last follow-up, respectively. Recurrent macular edema with a rebound increase of central retinal thickness was observed 3 months after the first injection, and improved after repeated bevacizumab injections. Patients received an average of 2 injections (range 1-3). FA showed no evidence of increased nonperfusion avascular area. No adverse ocular or systemic events were observed following injections.

CONCLUSIONS: The observed anatomic and visual acuity improvements after intravitreal bevacizumab injection demonstrate that bevacizumab is a useful adjunctive treatment for ME secondary to RVO without safety concerns in a short term. However, repeated injections are needed to maintain visual improvement. Long-term study is warranted to assess the long-term efficacy and safety.

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