Natural Short-term Course of Recurrent Macular Edema Following Intravitreal Bevacizumab Therapy in Branch Retinal Vein Occlusion

Abstract

PurposeTo evaluate the 3-month natural course of recurrent macular edema secondary to branch retinal vein occlusion (BRVO) treated with intravitreal bevacizumab.MethodsThis retrospective, observational study included 36 eyes with macular edema secondary to BRVO. All patients were initially treated with intravitreal bevacizumab for macular edema. Recurrence of macular edema was either not treated (untreated group) or treated with a single intravitreal bevacizumab injection (treated group). Central foveal thickness (CFT) and best-corrected visual acuity (BCVA) were compared at the time of recurrence and 3 months later.ResultsAt the time of recurrence, the mean CFT and logarithm of the minimum angle of resolution BCVA were 484.9 ± 124.1 µm and 0.58 ± 0.26 in the untreated group (n = 19) and 456.3 ± 126.8 µm and 0.51 ± 0.21 in the treated group (n = 17), respectively. Three months later, the mean CFT and BCVA had changed to 493.7 ± 123.9 µm and 0.62 ± 0.29 in the untreated group and 294.7 ± 104.4 µm and 0.40 ± 0.24 in the treated group, respectively. The differences in CFT and BCVA between the two time points were not significant in the untreated group (p = 0.106 and p = 0.687, respectively), whereas statistically significant differences were noted in the treated group (p = 0.002 and p < 0.001, respectively).ConclusionsUnlike the first episode of macular edema following BRVO, recurrent macular edema following intravitreal bevacizumab therapy did not spontaneously resolve, suggesting the potential benefit of prompt treatment.

Changes in retinal ischaemic index correlate with recalcitrant macular oedema in retinal vein occlusion: WAVE study

“…Thus, we are unable to determine what contribution the TRP actually had in the resolution of ME in these individuals. On the other hand, our patients did receive an average of 10 anti-VEGF treatment prior to enrolment and had persistent oedema which would make subsequent spontaneous resolution of ME seem less likely 22. A second limitation of our analysis was that we used a single FA image instead of a montaged FA image to assess NP.…”

Correlation between macular edema recurrence and macular capillary network destruction in branch retinal vein occlusion

“…However, many cases still require re-treatment because of recurrence or persistence of ME despite intravitreal anti-VEGF and/or steroid injection therapy [ 7 – 9 ]. Yoo et al [ 10 ] reported that recurrent ME requires more aggressive treatment and that spontaneous resolution without any treatment is very rare.…”

Correlation between macular edema recurrence and macular capillary network destruction in branch retinal vein occlusion

“…However, many cases still require re-treatment due to recurrence or persistence of ME despite intravitreal anti-VEGF and/or steroid injection therapy [7][8][9]. Yoo et al [10] reported that recurrent ME requires more aggressive treatment and spontaneous resolution without any treatment is very rare. ME related to retinal vascular disorders is known to be associated with regulation of the flow of fluid in macular capillaries, according to Spaide's [11] new theory.Edema in BRVO mainly happens in the same areas of altered macular capillary flow [11].…”