J Korean Ophthalmol Soc.  2010 May;51(5):707-715.

Intravitreal Bevacizumab Treatment of Macular Edema in Central Retinal Vein Occlusion

• Choi SW
• Kim HW
• Yun IH

Abstract

PURPOSE
To report the effect of intravitreal injection of bevacizumab for the treatment of macular edema due to central retinal vein occlusion (CRVO).
METHODS
In a retrospective study, 18 consecutive patients (18 eyes) with macular edema from CRVO received intravitreal bevacizumab (1.25 mg). Ophthalmic examination included best corrected visual acuity (BCVA) and central macular thickness (CMT) at baseline and follow-up visits. Fluorescein angiography was performed during follow-up visits if necessary. Primary outcomes included a change in BCVA and CMT.
RESULTS
The mean duration from symptom detection to the first bevacizumab injection was 32.5 days. The patients received a mean of 2.17 injections of bevacizumab per eye. The mean baseline visual acuity (LogMAR) was 1.27 and increased to a mean of 0.75 at 5 weeks, and 0.81 at 24 weeks. The mean central macular thickness at baseline was 640.5 micrometer and decreased to a mean of 295.6 micrometer at 5 weeks and 284.7 micrometer at 24 weeks (p<0.05). In the ischemic CRVO group, no significant changes in visual acuity were found after 24 weeks. The increase in visual acuity did not correlate significantly with the decrease in CMT after 24 weeks (p=0.205). The result from the non-ischemic group was similar to the preceding result (p=0.151).
CONCLUSIONS
Intravitreal bevacizumab resulted in a significant decrease in CMT in patients with CRVO after a 6-month follow-up. The visual acuity in patients with non-ischemic CRVO improved, but there was no significant improvement in the ischemic CRVO group.

Keyword

Bevacizumab; Central retinal vein occlusion; Intravitreal injection; Macular edema

MeSH Terms

Antibodies, Monoclonal, Humanized
Eye
Fluorescein Angiography
Follow-Up Studies
Humans
Intravitreal Injections
Macular Edema
Retinal Vein
Retrospective Studies
Visual Acuity
Bevacizumab
Antibodies, Monoclonal, Humanized

Figure

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  Figure 1. Change in retinal thickness after bevacizumab injection. A 62-year-old patient (No. 5) presented with non-ischemic central vein occlusion (A and B). He had symptoms for 2 weeks. Visual acuity reduced to 20/1000, and the macula was thickened (680 μm). Only the first injection of bevacizumab led to distinct decrease of retinal thickness to 166 μm (C and D). Visual acuity Improved to 20/40.

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  Figure 2. Boxplot showing the change in visual acuity (LogMAR) in 18 patients with central retinal vein occlusion after intravitreal injection of 1.25 mg bevacizumab, at baseline, 5, 12, 18, and 24 weeks after the first intravitreal injection.

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  Figure 3. Boxplot showing the change in central retinal thickness (μm) as measured by optical coherence tomography in 18 patients with central retinal vein occlusion after intravitreal injection of 1.25mg bevacizumab, at baseline, 5, 12, 18, and 24 weeks after the first intravitreal injection.

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  Figure 4. Boxplot showing the change in visual acuity (LogMAR) in 12 patients with non-ischemic, central retinal vein occlusion after intralvitreal injection of 1.25 mg bevacizumab, at baseline, 5, 12, 18, and 24 weeks after the first intravitreal injection.

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  Figure 5. The relationship between visual acuity increase and macular thickness decrease at 5 weeks (A) and 24 weeks (B) after intravitreal bevacizumab injections in patients with non-ischemic, central retinal vein occlusion, respectively.

Reference

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