Long-term effect of early intervention with single intravitreal injection of bevacizumab followed by panretinal and macular grid photocoagulation in central retinal vein occlusion (CRVO) with macular edema: A pilot study

Abstract

Purpose To evaluate the effect of single-dose intravitreal bevacizumab followed by panretinal and macular grid laser, early in the course of central retinal vein occlusion (CRVO). Methods It is a prospective, non-randomized, interventional study of nine eyes of nine patients with o10 days origin of CRVO who received 2.5 mg (0.1 ml) intravitreal bevacizumab, followed 3 weeks later by panretinal and macular grid photocoagulation. Its effect on visual acuity and anatomical features of CRVO were studied. Results Nine eyes of nine patients (male : female ¼ 8 : 1, mean age 54 years), with o10days (average 2.67days) onset of CRVO, received intravitreal bevacizumab within 7 days of presentation (average 3.1days) followed 3 weeks later by panretinal with macular grid laser. Presenting mean baseline visual acuity was 20/320 (1.2 logarithm of the minimum angle of resolution (LOGMAR) units). All the patients showed rapid improvement in the form of rapid clearance of retinal hemorrhages, decreased optic disc swelling and venous dilation, and tortuosity. Mean final visual acuity was 20/63 (0.5 LOGMAR units). No patient showed conversion from non-ischemic to ischaemic CRVO, recurrence of macular edema, and disc collateral formation. Conclusion Early intravitreal bevacizumab followed by panretinal and macular grid laser may provide visually and anatomically favourable results in a case of CRVO. It may also obviate the need for repeated injection. It requires a large randomized study to substantiate the results.

Three intravitreal bevacizumab versus two intravitreal triamcinolone injections in recent onset central retinal vein occlusion

“…). This has been advocated in some other studies (Shah & Shah ; Campochiaro ) and discouraged by some other (DeCroos et al. ).…”

Clinico-epidemiological characteristics of central retinal vein occlusion in a tertiary level eye care center of Nepal

“…Similarly, a study done by Zhang et al showed ischemic CRVO in 633 eyes (67.1 %) and nonischemic CRVO in 311 eyes (32.9 %) (Zhang and Xia, 2002). In a prospective study of nine eyes of nine patients with CRVO, 5 of the 9 eyes (55.5 %) had ischemic CRVO and 4 of the 9 (44.4 %) eyes had non-ischemic CRVO (Shah and Shah, 2011). The present study was a hospital-based study and the selection bias could not be eliminated completely.…”

“…The risk of CRVO is reduced with increasing levels of physical activity and in women with use of postmenopausal estrogens (1996). Various modalities of interventions such as systemic anticoagulation, panretinal photocoagulation (PRP), macular grid photocoagulation, hemodilution, dexamethasone sustained-release implant, intravitreal anti-VEGF agents and triamcinolone acetonide are used for the treatment of CRVO (Shah and Shah, 2011).…”

The ABCs of RVO: A review of retinal venous occlusion

“…Indeed, only 10 per cent of patients presenting with ischaemic central RVO maintain a final VA better than 6/120 . Continued vigilance is required as conversion to ischaemic central RVO heralded by acuity dropping to 6/60 or less occurs in up to 34 per cent of initially non‐ischaemic cases within three years, albeit most rapidly in the first four months . That being said, given that much of our knowledge of the natural history of central RVO has been derived from post‐hoc analyses, any prognostication must be taken with a grain of salt …”