Intravitreal Bevacizumab Injections in Cases of Central Retinal Vein Occlusion with Macular Edema -Case Series

Abstract

Purpose: To report the safety and morphologic effects of intravitreal bevacizumab (Avastin) injections in eyes with macular edema due to central retinal vein occlusion (CRVO).Methods: This study is a retrospective case series of patients diagnosed with macular edema secondary to CRVO and treated with intravitreal bevacizumab injections. Patients underwent best corrected visual acuity (BCVA) with conversion to logMAR (logarithm of minimal angle of resolution) in baseline visits. Central macular thickness (CMT) on OCT was documented at baseline, one month, three months, and six months after intravitreal bevacizumab injection. We compared the changes of CMT from before and 1 month after each injection. Statistical analysis was done with paired Student t-test.Results: The median age of the eight patients was 54.6 years (54.6 ± 21.1, range 23-82). The mean presenting BCVA LogMAR was 0.79. Mean follow-up time was 8.3 months (8.3 ± 3.62, range 6-17 months). Mean numbers of injections were 1.75 (1.75 ± 0.89, range 1-3). Regarding the OCT findings, the median presenting central macular thickness (CMT) was 723.8 (723.8 ± 279.3, range 376-1194); mean final CMT was 323.5 (323.5 ± 276.6, range 119-937). Among the eight patients reported, no significant ophthalmic or systemic complications were noted. These eight injections resulted in significant CMT reduction upon one month follow-up (mean reduction 516.9 ± 274.4, p = 0.001). Four patients presented with recurrent macular edema, and the onset ranged from one month to 4 months.Conclusions: Intravitreal bevacizumab injection is a safe procedure in treating macular edema secondary to CRVO. It results in significant decrease in macular edema. However, the effect is relatively short and transient, with frequently observed recurrent macular edema. Repeated injection might be needed to establish a long-term favorable outcome.