Intravitreal bevacizumab for macular edema due to branch retinal vein occlusion: 12-month results

Abstract

Purpose:To present the functional and anatomic changes after intravitreal bevacizumab in eyes with macular edema (ME) due to branch retinal vein occlusion (BRVO).Design:The study was a retrospective study.Materials and methods:The study included 31 patients with ME due to BRVO. We compared the examination findings of patients with ME before and after intravitreal bevacizumab therapy at 12 months. The study included patients who had macular edema secondary to BRVO treated with bevacizumab. The therapy was started in the first week after occlusion. The initial therapy was three intravitreal bevacizumab injections at monthly intervals with 1.25/0.05 mL bevacizumab. Patients with a baseline visual acuity less than 0.5 (logarithm of the minimum angle of resolution [logMAR] 0.30), central macular thickness (CMT) more than 290 μm, and no neovascularization were included. Patients with diabetes mellitus or a history of intravitreal triamcinolone or grid laser photocoagulation therapy or ischemic BRVO were excluded. The retreatment criteria were as follows: increased CMT more than 100 μm combined with a loss of visual acuity of five or more letters. The statistical analysis of this study was carried out by paired samples t-test (SPSS). A P value of less than 0.05 was considered to be statistically significant.Results:This retrospective study included 33 eyes of 31 patients (20 women, 11 men; mean age was 55.30 ± 9.62 years (range 36–75 years). Patients received a mean of 5.3 injections during 12 months of follow-up. The best corrected visual acuity increased from 0.66 ± 0.20 (logMAR) at baseline to 0.22 ± 0.13 (logMAR) (t = 15.42; P < 0.001) at month 12. The CMT decreased from 494.15 ± 104.16 μm at baseline to 261.79 ± 45.36 μm at month 12 (− 232.36 ± 109.98 μm); P < 0.001). No bevacizumab-related systemic or ocular adverse effects following intravitreal drug injections were observed. The majority of patients required reinjection(s) treatment for ME (84.9%).Conclusion:Intravitreal therapy using bevacizumab appears to be an effective primary treatment option for ME due to BRVO. No serious ophthalmologic or systemic side effects were observed for intravitreal bevacizumab therapy. The main disadvantage of bevacizumab therapy is the requirement of multiple injections in order to maintain visual and anatomic improvements.

Intravitreal bevacizumab in macular edema secondary to branch retinal vein occlusion: 12-month results

“…The mean age was slightly higher than the series by Demir et al11 but was lower than the other published series 9–12. The male predominance in our case series could be due to the privilege of males in Nepalese society, which ensures better access to health facilities.…”

Onset and Duration of Visual Acuity Improvement After Dexamethasone Intravitreal Implant in Eyes With Macular Edema Due to Retinal Vein Occlusion

“…20 Rapid improvement in BCVA, seen in the GENEVA study at Day 7 after DEX implant treatment, also occurs with other intravitreal therapies. Ranibizumab injections were given monthly in the 6-month Phase 3 trials for regulatory approval, 10,11 and evidence suggests that repeat injections of anti-VEGF therapy may be needed every 1 to 2 months to sustain functional and anatomic improvements in both BRVO 12,13 and CRVO. 21 In the 6-month BRAVO and CRUISE studies in patients with ME associated with BRVO and CRVO, respectively, intravitreal anti-VEGF treatment with ranibizumab provided rapid improvement in BCVA compared with sham procedure, with a difference between treatment groups evident by postinjection Day 7 in each study.…”

“…[1][2][3] It has been estimated that 16 million adults worldwide, most of them being older than 60 years, are affected by RVO. [5][6][7][8][9][10][11][12][13][14][15] A sustained-delivery dexamethasone intravitreal implant 16 (DEX implant 0.7 mg; Ozurdex, Allergan, Inc., Irvine, CA), which provides controlled release of dexamethasone from a biodegradable copolymer, was the first approved medical treatment for RVOassociated ME. Treatment options include intravitreal corticosteroid and anti-vascular endothelial growth factor (anti-VEGF) therapies.…”

Current antiangiogenic agents in oncology and ophthalmology

“…Intravitreal application with antiangiogenic drugs is frequently used by treatment of diabetic retinopathy, age-related macular degeneration, retinopathy of prematurity and retinal vein occlusion (RVO) complications [45][46][47][48], (Fig.1,2).…”