Randomized Study of Intravitreal Injection of Bevacizumab in the Treatment of Persistent Uveitic Macular Edema

Abstract

Objective: To assess the efficacy and safety of Bevacizumab IVT in the treatment of persistent uveitic macular edema Methods: This is a prospective randomized interventional study of 20 eyes of 20 macular edema patients with different types of uveitis in remission but persistent to conventional therapy who were treated with Bevacizumab IVT, with short- and medium-term results collected and analyzed. Results: The improvement in VA was significant as early as week 12, and at 12 months reached 80%. The mean logMAR VA was initially 0.78. After 1 year, it decreased to 0.57. 16 patients (80%) had at least 2 lines of VA gain at 1-year follow-up. Reinjection was required in the majority of cases. 8 patients (40%) had a 2nd IVT of Bevacizumab and 5 patients (25%) had 3 IVT of Bevacizumab. After one or more IVT of Bevacizumab, the improvement of at least 2 lines of VA at 12, 24 weeks and 1 year were 45%, 60% and 80% respectively. 65% of our patients had a central macular thickness <300 μm at 1 year follow-up. The mean central macular thickness was initially 546.55 μm, after 1 year of follow-up, the central macular thickness was 369.95 μm. After 3 months of follow-up, there was a reduction of at least 60 μm, and after 1 year of follow-up, the reduction in central macular thickness was at least 100 μm and this affected 65% of patients. No serious ocular or systemic side effects were observed. Conclusion: These results demonstrate that intravitreal injection of Bevacizumab in the treatment of persistent uveitic macular edema well tolerated, with short- and medium-term improvement in visual acuity and central macular thickness in a significant number of cases.