Intravitreal Injection of Bevacizumab for Macular Edema Secondary to Branch Retinal Vein Occlusion

Kondo, Mineo; Kondo, Nagako; Ito, Yasuki; Kachi, Shu; Kikuchi, Masato; Yasuma, Tetsuhiro; Ota, Ichiro; Miyake, Kensaku; Terasaki, Hiroko

doi:10.1097/iae.0b013e3181aa8e20

Cited by 85 publications

(82 citation statements)

References 27 publications

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“…data, 2009] affirm that it is better if associated with grid laser, but we wait for results of other studies to clarify this point. Second, most of the patients needed repeated injections to achieve good results, depending on the different studies [47,48,53,54]; the Pan-American Collaborative Retina Study group showed these high rates of injections in 24 months [48]. Third, there is no defined long-term therapeutic scheme and it is also not known when to start the treatment.…”

Section: Treatmentmentioning

confidence: 99%

“…They are also useful to reduce ischemic progression and to manage complications, such as neovascular glaucoma [61]. There are some prognostic factors for better outcome, such as better initial VA, no foveal hemorrhages, no macular ischemia, detection of VA gain after first injection, young age and final central retinal thickness [45,48,62,63]. But there are limits in efficacy, need for multiple injections, rebound effect of macular edema and nonresponders.…”

Section: Treatmentmentioning

confidence: 99%

“…But there are limits in efficacy, need for multiple injections, rebound effect of macular edema and nonresponders. In fact, there are no studies of long-term efficacy, even when it is known that the efficacy is lost after 3 consecutive injections (the loading phase) [48]. Donati et al [unpubl.…”

Section: Treatmentmentioning

confidence: 99%

“…The dosage varies between 1 and 2.5 mg, there are no different outcomes [39,40,41,42,43,44,45,46,47,48]. The Pan-American Collaborative Retina Study group concluded that intravitreal injections of bevacizumab at doses up to 2.5 mg were more effective in improving VA and reducing macular edema at 6 months (compared to 1.25 mg), but the study had no control group [44].…”

Section: Treatmentmentioning

confidence: 99%

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Retinal Vein Occlusion: Current Treatment

Lattanzio¹,

Gimeno

Parodi³

et al. 2010

Ophthalmologica

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Retinal vein occlusion (RVO) is a pathology noted for more than 150 years. Although a lot has been written on the matter, it is still a frequent condition with multifactorial etiopathogenesis with many unclear aspects. The RVO pathogenesis has varied systemic and local implications that make it difficult to elaborate treatment guidelines. The management of the patient with RVO is very complex and a multidisciplinary approach is required in order to identify and correct the associated risk factors. Laser therapy remains the gold standard in RVO, but only modest functional improvement has been shown in branch retinal occlusion forms. Multicenter studies of intravitreal drugs present them as an option to combine with laser. Anti-vascular endothelial growth factor, corticosteroids and sustained-release implants are the future weapons to stop disease progression and get a better visual outcome. Consequently, it is useful to clarify some aspects of the pathology that allow a better patient management.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

See 2 more Smart Citations

Retinal Vein Occlusion: Current Treatment

Lattanzio¹,

Gimeno

Parodi³

et al. 2010

Ophthalmologica

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“…The treatment options for BRVO include grid laser treatment, intravitreal injection of steroids, surgical procedures and off-label treatment with intravitreal anti-vascular endothelial growth factor (VEGF) agents [1,2]. In recent years, intravitreal anti-VEGF treatment with bevacizumab has been shown to efficiently reduce macular edema and improve visual acuity in numerous case series and prospective or retrospective studies [3,4,5,6,7]. …”

Section: Introductionmentioning

confidence: 99%

Intravitreal Bevacizumab and Cytokine Levels in Major and Macular Branch Retinal Vein Occlusion

Lim¹

2010

Ophthalmologica

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Purpose: My aim was to evaluate the effect of intravitreal bevacizumab and to determine the concentrations of inflammatory cytokines in patients with macular edema due to branch retinal vein occlusion (BRVO), according to the site of the occlusion. Methods: In a prospective interventional case series, 46 eyes of patients with macular edema due to major (n = 30) or macular BRVO (n = 16) were included. The patients were treated primarily with intravitreal bevacizumab (1.25 mg/0.05 ml) and completed 12 months of follow-up. Reinjections were performed if optical coherence tomography showed persistent or recurrent macular edema. Aqueous humor samples were collected at the time of initial intravitreal injection. Multiplex bead assays were used for the measurement of cytokines. Results: The visual acuity and central macular thickness were improved significantly in patients with major and macular BRVO at 12 months. During 12 months, the eyes with major BRVO received a mean of 3.8 intravitreal injections, whereas those with macular BRVO received a mean of 1.9 intravitreal injections (p = 0.009). Significantly increased concentrations of IL-6, IL-8 and MCP-1 were observed in the aqueous humor of BRVO patients compared with control samples. Higher concentrations of IL-6, VEGF, PDGF-AA and MCP-1 were measured in the aqueous humor of patients with major BRVO compared with macular BRVO at baseline (p < 0.05). Conclusion: Intravitreal bevacizumab was similarly effective for improving macular edema in patients with major and macular BRVO. However, macular BRVO required fewer injections and had lower cytokine levels in the aqueous humor than major BRVO.

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Antimicrobial Resistance and Ophthalmic Antibiotics

Kim¹

2011

Arch Ophthalmol

103

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Objective: To determine antibiotic susceptibility patterns of conjunctival flora from patients undergoing intraocular injection for choroidal neovascularization after repeated exposure to ophthalmic antibiotics. Methods: We conducted a randomized, controlled, longitudinal study of 48 eyes of 24 patients undergoing unilateral intraocular injection for choroidal neovascularization. Bilateral conjunctival cultures from the treated eye and untreated (control) fellow eye were taken at baseline and after each injection (before the application of povidone-iodine). Patients were randomized to ofloxacin, 0.3%; azithromycin, 1%; gatifloxacin, 0.3%; or moxifloxacin hydrochloride, 0.5% and used only their assigned antibiotic after each injection. Bacterial isolates were tested for antibiotic susceptibility to 16 different antibiotics, and analysis of bacteria DNA was performed using pulse-field gel electrophoresis. Main outcome measures included changes in antibiotic susceptibility patterns of conjunctival flora after 1 year. Results: Coagulase-negative staphylococci (CNS) cultured from eyes repeatedly exposed to fluoroquinolone antibiotics demonstrated significantly increased rates of resistance to older-generation (P = .002) and newergeneration (PϽ.01) fluoroquinolones. In contrast, CNS isolated from azithromycin-exposed eyes demonstrated significantly increased resistance to macrolides (95%; P Ͻ .001) and decreased resistance to older-generation (P =.03) and newer-generation (PϽ .001) fluoroquinolones. There were significant increases in multiple-drug resistance of CNS isolated from treated eyes, with 81.8% and 67.5% of isolates resistant to at least 3 (P =.01) and at least 5 (P =.009) antibiotics, respectively. Conclusion: Repeated exposure of conjunctival flora to ophthalmic antibiotics selects for resistant strains. Application to Clinical Practice: Repeated use of ophthalmic antibiotics after intraocular injection promotes the emergence of antimicrobial resistance.

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Intravitreal Injection of Bevacizumab for Macular Edema Secondary to Branch Retinal Vein Occlusion

Abstract: Intravitreal bevacizumab therapy can be a long-term effective treatment for macular edema secondary to branch retinal vein occlusion.

Cited by 85 publications

References 27 publications

Retinal Vein Occlusion: Current Treatment

Retinal Vein Occlusion: Current Treatment

Intravitreal Bevacizumab and Cytokine Levels in Major and Macular Branch Retinal Vein Occlusion

Antimicrobial Resistance and Ophthalmic Antibiotics

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