Abstract
Purpose: To assess the efficacy of intravitreal bevacizumab (IVB) combined with grid photocoagulation in the management of recurrent macular edema secondary to retinal vein occlusion (RVO). Methods: This is a prospective, non-randomized, interventional study. Thirty five eyes with branch retinal vein occlusion (BRVO) and 15 eyes with central retinal vein occlusion (CRVO) were treated with grid photocoagulation combined with IVB for recurrent macular edema. The visual acuity, central macular thickness and intraocular pressure were outcome measures. The mean duration of follow-up was 18.1 ± 3.6 months. Results: One month after treatment, 45 of the 50 eyes showed complete resolution of the cystoid space. Compared with initial values, final central macular thickness was reduced significantly in both BRVO and CRVO groups (P P = 0.012). The total number of IVB was 1.8 ± 0.3 for eyes with either BRVO or CRVO. Conclusion: IVB combined with grid photocoagulation is an effective treatment for reducing recurrent macular edema associated with RVO.
Highlights
Macular edema remains one of the most frequent cause of visual impairment associated with retinal vein occlusion (RVO)
In a collaborative retina study, the mean number of 1.25 mg intravitreal bevacizumab (IVB) injections over a 24-month period was 7.2 for the treatment of macular edema associated with central retinal vein occlusion (CRVO) [10]
With monthly injections for a 6 month period, retinal thickening was continuously resolved and more than 40% of eyes with CRVO and more than 50% of eyes with branch retinal vein occlusion (BRVO) gained 15 letters on VA testing, and a VA of equal to or better than 20/40 was achieved in 40% of eyes with CRVO and in 60% of eyes with BRVO
Summary
Macular edema remains one of the most frequent cause of visual impairment associated with retinal vein occlusion (RVO). Vascular endothelial growth factor (VEGF), which is a potent inducer of increased vascular permeability that causes leakage from retinal vessels and contributes to macular oedema [4]. Noma et al [6] reported that increased intraocular levels of VEGF and sICAM-1 or a decreased level of PEDF are associated with increased vascular permeability and the severity of retinal ischemia in BRVO patients. Laser and steroid treatment for patients with RVO have had statistically significant benefits in terms of retinal thickening and visual acuity, but with several limitations [7]
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