Abstract
Purpose:To investigate the effect of intravitreal bevacizumab (IVB) injection on macular edema (ME) secondary to Behcet's disease.Methods:This prospective case series included 15 patients with bilateral ME due to Behcet's disease. Intravitreal bevacizumab was injected into the more severely involved eye; the contralateral eye was evaluated as the control. Patients were followed up with comprehensive ocular examination, optical coherence tomography, and fluorescein angiography (FA) for a minimum of 6 months by a single ophthalmologist.Results:Patients with a mean age of 30.6 ± 7.4 years received a mean number of 3.3 IVB injections during the 6 months. The mean preinjection vision was 0.6 ± 0.3 and 0.4 ± 0.4 LogMAR in the case and control groups, respectively, with no significant improvement at 6 months. Mean central foveal thickness was 375.3 ± 132.1 and 307.2 ± 84.5 μm in the case and control groups, respectively, and these changed to 401 ± 199.9 (P = 0.65) and 307.7 ± 82.8 μm (P = 0.73) at month 6, respectively. A statistically nonsignificant improvement in ME was observed during the first 3 months in the case group. However, it did not persist up to month 6 on an as-needed basis. IVB injections caused a disproportionate decrease in the thickness of macular subfields. A reduction in disc leakage was observed on FA (P = 0.058). Logistic regression analysis revealed no statistically significant predictive factor for an improvement in visual acuity (VA) and a reduction in foveal thickness.Conclusion:During a 6-month period, IVB injections based on an as-needed protocol provided no statistically significant improvement in VA and ME.
Highlights
Intravitreal Bevacizumab and Macular Edema in Behcet Disease; Ghassemi et al seen during the early years.[4,5]
The mean duration of uveitis was 5.11 ± 2.4 years, and macular edema (ME) was present for a mean duration of 1.11 ± 0.3 years
All eyes in the case and control groups were panuveitic according to the standardization of uveitis nomenclature with the presence of nonvisually significant posterior subcapsular cataract in five eyes in the case group and four eyes in the control group, without significant changes during the study period
Summary
Behcet’s disease (BD) is a multisystem vasculitis of unknown etiology.[1,2,3] Ocular involvements are most often. Intravitreal Bevacizumab and Macular Edema in Behcet Disease; Ghassemi et al seen during the early years.[4,5] In BD, cystoid macular edema (CME) has been reported to be responsible for visual acuity (VA) less than 20/60, leading to permanent or persistent visual loss in 42% of patients with BD.[6,7,8] Previous studies have reported many systemic treatments with limited success in improving VA (8.8–24.8%) in BD with ocular involvement.[9,10,11,12,13,14,15]
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