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Intravitreal bevacizumab (Avastin®) for macular edema secondary to retinal vein occlusion - twelve-month results of a prospective clinical trial
  1. Franz Prager (franz.prager{at}meduniwien.ac.at),
  2. Stephan Michels (stephan.michels{at}usz.ch),
  3. Katharina Kriechbaum (katharina.kriechbaum{at}meduniwien.ac.at),
  4. Michael Georgopoulos (michael.georgopoulos{at}meduniwien.ac.at),
  5. Marion Funk (marion.funk{at}meduniwien.ac.at),
  6. Wolfgang Geitzenauer (wolfgang.geitzenauer{at}meduniwien.ac.at),
  7. Kaija Polak (kaija.polak{at}meduniwien.ac.at),
  8. Ursula Margarethe Schmidt-Erfurth (ursula.schmidt-erfurth{at}meduniwien.ac.at)
  1. Medical University of Vienna, Austria
  2. University Hospital Zurich, Switzerland
  3. Medical University of Vienna, Austria
  4. Medical University of Vienna, Austria
  5. Medical University of Vienna, Austria
  6. Medical University of Vienna, Austria
  7. Medical University of Vienna, Austria
  8. Medical University of Vienna, Austria

    Abstract

    Objectives: To evaluate functional and anatomical changes after intravitreal bevacizumab (Avastin®) in eyes with persistent macular edema secondary to branch (BRVO) or central (CRVO) retinal vein occlusion.

    Methods: Twenty-nine consecutive eyes with macular edema secondary to BRVO (21 eyes) or CRVO (8 eyes) were included in a prospective clinical trial. Eyes were treated with 3 initial intravitreal bevacizumab injections of 1 mg at a monthly interval. Retreatment was based on central retinal thickness (CRT) based on optical coherence tomography (OCT). If continuous injections were indicated up to month 6, the dose was increased to 2.5 mg.

    Results: After 12 months of follow-up, mean visual acuity increased from 49.7 letters (20/100) at baseline to 65.5 letters (20/50+1; +15.8 letters; p<0.001) at month 12 and CRT decreased from 558 µm at baseline to 309 µm (-249 µm; p<0.001) at month 12. All patients received a mean of 8 out of 13 possible injections. No drug-related systemic or ocular side effects following intravitreal bevacizumab treatment were observed. Fluorescein angiography revealed no progression of avascular areas.

    Conclusion: Intravitreal therapy using bevacizumab appears to be a safe and effective method in patients with macular edema secondary to RVO. However, main limitation of this treatment modality is its short durability and high recurrence rate.

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