Results of bevacizumab as the primary treatment for retinal vein occlusions.
Résumé
Background: Our purpose was to evaluate the efficacy of intravitreal bevacizumab as the primary treatment of macular edema due to retinal vein occlusions. Methods: Patients diagnosed with central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO) with visual acuity (VA) of less than 20/40 and macular edema with more than 300 ƒÝm central retinal thickness were recruited. Patients that had received any prior treatment were excluded. After an initial intravitreal injection of bevacizumab, re-treatment was performed if intra- or subretinal fluid with distortion of the foveal depression was found in optical coherence tomography. Results: 18 eyes with CRVO and 28 eyes with BRVO were included. During a 6-month period, the mean number of injections per patient was 3.7 (BRVO group) and 4.6 (CRVO group). In the BRVO group, mean baseline logMAR VA was 0.80 (SD 0.38) and macular thickness was 486.9 ƒÝm (SD 138.5 ƒÝm). After six months, mean logMAR VA improved significantly to 0.44 (SD 0.34), p<0.001. Mean macular thickness decreased significantly to 268.2 ƒÝm (SD 62.5 ƒÝm), p< 0.001. In the CRVO group, mean baseline logMAR VA was 1.13 (SD 0.21) and macular thickness was 536.4 ƒÝm (SD 107.1 ƒÝm). Mean final logMAR VA improved significantly to 0.83 (SD 0.45), p<0.001. Mean macular thickness decreased significantly to 326.17ƒÝm (SD 96.70 ƒÝm), p< 0.001. Conclusions: Intravitreal bevacizumb seems to be an effective primary treatment option for macular edema due to retinal occlusions. Its main drawback is that multiple injections are necessary to maintain visual and anatomic improvements.
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