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INTRAVITREAL BEVACIZUMAB (AVASTIN) TREATMENT OF MACULAR EDEMA IN CENTRAL RETINAL VEIN OCCLUSION: A Short-Term Study

ITURRALDE, DIANA MD; SPAIDE, RICHARD F. MD; MEYERLE, CATHERINE B. MD; KLANCNIK, JAY M. MD; YANNUZZI, LAWRENCE A. MD; FISHER, YALE L. MD; SORENSON, JOHN MD; SLAKTER, JASON S. MD; FREUND, K BAILEY MD; COONEY, MICHAEL MD; FINE, HOWARD F. MD, MHSc

Original Articles
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Purpose: To report the short term anatomic and visual acuity response after intravitreal injection of bevacizumab (Avastin, Genentech) in patients with macular edema due to central retinal vein occlusion (CRVO).

Methods: The authors conducted a retrospective study of patients with macular edema due to CRVO who were treated with at least one intravitreal injection of bevacizumab 1.25 mg in 0.05 mL. Patients underwent Snellen visual acuity testing, optical coherence tomography (OCT) imaging, and ophthalmoscopic examination at baseline and follow-up visits.

Results: There were 16 eyes of 15 consecutive patients with a mean age of 76.1 years (SD 9.8 years). Intravitreal triamcinolone had been previously administered to 9 patients, but all of these patients either had no improvement or had excessive intraocular pressure caused by the triamcinolone. The patients received a mean of 2.8 injections of bevacizumab per eye. No adverse events were observed, including endophthalmitis, clinically evident inflammation, increased intraocular pressure, retinal tears, retinal detachment, or thromboembolic events in any patient. The mean central macular thickness at baseline was 887 μm and decreased to a mean of 372 μm at month 1 (P < 0.001). The mean baseline acuity was 20/600 (logMAR = 1.48) and the mean acuity at month 1 was 20/200 (logMAR = 1.05), a difference that was highly significant (P = 0.001). At last follow-up, a mean of 3 months after the first injection, the mean visual acuity was 20/138 (logMAR = 0.84), which was significantly better than baseline (P < 0.001). Visual acuity improvement, defined as a halving of the visual angle, was seen in 14 of the 16 eyes.

Conclusion: Initial treatment results of patients with macular edema secondary to CRVO did not reveal any short-term safety concerns. Intravitreal bevacizumab resulted in a significant decrease in macular edema and improvement in visual acuity. The number of patients in this pilot study was limited and the follow-up is too short to make any specific treatment recommendations, but the favorable short-term results suggest further study is needed.

A retrospective study of 16 eyes in 15 patients found that intravitreal bevacizumab was associated with a reduction in macular edema and an improvement in visual acuity, at least in the short term, when administered for macular edema secondary to central retinal vein occlusion.

From the Vitreous, Retina, Macula Consultants of New York, NY.

The authors have no proprietary interests in this study.

Reprint requests: Richard F. Spaide, 460 Park Avenue, 5th Floor, New York, NY 10022; e-mail: vrmny@aol.com

© The Ophthalmic Communications Society, Inc.