Bevacizumab therapy for macular edema in central retinal vein occlusion: Long-term results.
ABSTRACT There is no proven effective treatment for vision loss in central retinal vein occlusion (CRVO). Bevacizumab has been reported in small series with limited follow-up, to have a positive effect in reducing cystoid macular edema (CME) and improving vision in CRVO.
To report long-term results with the use of bevacizumab in CRVO.
Prospective interventional case series included 15 patients, serially evaluated with best corrected visual acuity (BCVA), optical coherence tomography (OCT), fluorescein angiography, and tonometry. Results were statistically analyzed.
Mean follow-up was 12 +/- 3.6 months (range, 6-18 months); mean number of injections was 2.2 (range, 1-4) per patient. Statistically significant reduction of macular thickness (P < 0.001) was seen at six weeks (mean, 346 mu); three months (mean, 353 mu); six months (mean, 348 mu); and final follow-up (mean, 342 mu). Significant BCVA improvement was seen at six weeks (mean, 0.27 logMAR), three months (mean, 0.3 logMAR), three months (0.15 logMAR), and final follow-up (mean, 0.21 logMAR) (P = 0.009). Also, 73.3% patients had BCVA improvement at the last follow-up.
Intravitreal bevacizumab is an effective treatment option for CME in CRVO patients. Reinjections at appropriate timing, based on the OCT findings, are important for better visual outcome.
- SourceAvailable from: Elias ReichelBritish Journal of Ophthalmology 03/2002; 86(2):247-8. · 2.73 Impact Factor
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ABSTRACT: To investigate the safety and efficacy of intravitreal triamcinolone acetonide as treatment for macular edema associated with central retinal vein occlusion (CRVO). We reviewed the medical records of 13 consecutive patients (13 eyes) with macular edema associated with CRVO who were treated with an injection of intravitreal triamcinolone acetonide (4 mg) at the University of Wisconsin and the Bascom Palmer Eye Institute. Each intravitreal injection was delivered through the pars plana using a 27- or 30-gauge needle. Change in Snellen visual acuity, clinical appearance of macular edema, measurement of foveal thickening with optical coherence tomography (OCT), and frequency of complications. The median age of the 13 patients was 67 years (interquartile range, 57-77 years), and the median duration of symptoms before injection was 8 months (interquartile range, 4-9 months). Mean baseline visual acuity was 20/500 in the affected eye. Mean visual acuity at the 6-month follow-up examination was 20/180 in the affected eye. All 13 patients completed the 6-month examination. Eyes with nonischemic CRVO (n = 5) demonstrated a significant improvement in visual acuity, whereas eyes with ischemic CRVO (n = 8) demonstrated a nonsignificant visual acuity improvement. No patient had a decrease in visual acuity. Mean baseline foveal thickness as measured by OCT was 590 micro m (retinal thickening = 416 micro m). Mean foveal thickness as measured by OCT at the 1-month follow-up examination in 12 patients was 212 micro m (retinal thickening = 38 micro m). At the 3-month follow-up examination, mean foveal thickness as measured by OCT for 13 patients was 193 micro m (retinal thickening = 19 micro m). Between the 3- and 6-month follow-up examinations, 4 patients developed a recurrence of macular edema. Three of the 4 patients were retreated with a second injection of triamcinolone. Two of these 3 patients experienced an improvement in visual acuity following retreatment. At the 6-month follow-up examination, mean foveal thickness as measured by OCT for 13 patients was 281 micro m (retinal thickening = 107 micro m). No adverse effects such as retinal detachment or endophthalmitis occurred. One patient experienced an increase in intraocular pressure that was controlled with 2 aqueous suppressants. Intravitreal injection of triamcinolone appears to be a possibly effective treatment in some patients with macular edema associated with CRVO. Patients with nonischemic CRVO may respond more favorably than patients with ischemic CRVO, and retreatment may be necessary in some patients. In this case series, severe complications were not noted.Archives of Ophthalmology 09/2004; 122(8):1131-6. · 3.83 Impact Factor
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ABSTRACT: To determine whether bevacizumab could improve visual acuity and optical coherence tomography outcomes in a patient with macular edema from central retinal vein occlusion, an intravitreal injection of bevacizumab (1.0 mg) was given. Prior intravitreal injections of triamcinolone acetonide resulted in vision improvement but worsening cataract and borderline glaucoma. Within 1 week of the bevacizumab injection, visual acuity improved from 20/200 to 20/50 and optical coherence tomography revealed resolution of the cystic maculopathy. The improvements were maintained for at least 4 weeks. Intravitreal injections of bevacizumab may provide another treatment option for patients with macular edema from vein occlusions.Ophthalmic Surgery Lasers and Imaging 01/2005; 36(4):336-9. · 1.46 Impact Factor