Bevacizumab zur Therapie des sekundären Makulaödems nach venösen Gefäßverschlüssen

Abstract

Application of VEGF inhibitors represents a treatment option for macular edema secondary to retinal vein occlusion that targets the disease at the causal molecular level. First reports on intravitreal injections of bevacizumab show promising morphological and functional effects and demonstrate that bevacizumab is a potent antiedematous agent in this context. A significant reduction of the central retinal thickness followed by a rapid improvement of visual acuity may be achieved within days. In a pilot study with a review period of 3 months, we found a significant improvement of one or more lines in 93% and four or more lines in 27% of eyes. This was associated with a concomitant significant reduction in central retinal thickness, which, however, was not sustained by a single injection (64% reduction after 1 month and 28% after 3 months). No relevant adverse events were noted. The duration of action after intravitreal bevacizumab administration is currently unknown. Reinjections will be necessary to maintain a lasting beneficial effect. Prospective, controlled long-term studies are mandatory to develop standardized treatment protocols that allow a safe and effective application of this off-label therapy.

Management of Retinal Vein Occlusion – Consensus Document

“…Since the landmark study on the intravitreal use of bevacizumab for the treatment of exudative age-related macular degeneration [100], bevacizumab has become a medication used worldwide for patients affected by various neovascular intraocular diseases including RVO [101,102,103,104,105,106,107]. …”

Early Intravitreal Bevacizumab for Non-Ischaemic Branch Retinal Vein Occlusion

“…The results of the BRVO study group have recommended a grid laser coagulation of the leaking region of the macula if visual acuity remains to be lower than 20/40 [2]. In view of the irreversible laser-induced loss of paracentral retinal tissue by the macular laser coagulation resulting in paracentral scotomata, the new anti-angiogenic drugs such as ranibizumab, pegabtanib and bevacizumab may offer new therapeutic modalities for the treatment of macular oedema secondary to BRVOs, without an observed retinal toxicity [3,4,5,6,7,8,9]. It was, therefore, the purpose of the present study to assess the effect and side-effects of intravitreally administered bevacizumab in eyes with a BRVO.…”

Effect of a Single Intravitreal Bevacizumab Injection on Contrast Sensitivity and Macular Thickness in Eyes with Macular Edema from Central Retinal Vein Occlusion: A Prospective, Nonrandomized, Three-Month Follow-Up Study

“…Until recently, no treatments have proven to be consistently effective for patients with ME resulting from CRVO. Nevertheless, in recent years, intraocular anti-VEGF drugs have increased in importance in treating ME caused by retinal vein occlusion [10,11,13,14,22]. …”

“…Retrospective and prospective studies have observed a significant decrease in ME and an improvement in visual acuity (VA), proving bevacizumab to be an effective treatment for CRVO [10,11,12,13,14]. …”