1-Year Follow Up Of Intravitreal Bevacizumab Therapy For Macular Edema Secondary To Branch Retinal Vein Occlusion

Michael Partsch

Purpose: To investigate the clinical and anatomic effect of intravitreal injections of bevacizumab (Avastin®) for secondary macular edema (ME) after branch retinal vein occlusion (BRVO).

Methods: Prospective analysis of the response to intravitreal injections in 26 patients with perfused ME. Patients with prior treatments were excluded. Complete ophthalmic examinations including optical coherence tomography (OCT) were performed every 6 weeks.

Results: Mean age was 68 years. Two patients were lost in follow up and excluded. 24 patients finished the 24 weeks follow-up, 12 patients finished the 48 weeks visit. Median time between symptoms of BRVO and first bevacizumab injection was 7.9 months (range, 2.8 to 16.6 months). Patients that finished the 24 weeks follow-up received an average of 1.6 reinjections per eye. The 12 patients with a follow-up of 48 weeks had an average of 2.2 reinjections. At baseline median visual acuity (VA) was 0.49 logMAR and increased to 0.3 logMAR at 6 weeks (P<0.001, gain of 1.9 lines), and remained at a stable level on follow-up visits. At 48 weeks follow-up (12 eyes) median VA increased from 0.45 logMAR at baseline to 0.22 logMAR at 48 weeks (P<0.001). Median baseline central retinal thickness (CRT) was 395µm and decreased to 305µm at week 24 (24 eyes). Median CRT at week 48 (12 eyes) was 235µm.

Conclusions: Our data indicates that Bevacizumab has a positive effect in patients with perfused ME secondary to BRVO. Both VA and ME showed a remarkable recovery. Re-injections are necessary for stabilisation of the reached effect.