Role of Intravitreal Injection bevacizumab (Avastin®) in Macular Edema after Central Retinal Vein Occlusion

Abstract

Introduction: No effective treatment modality has been found for vision loss in central retinal vein occlusion (CRVO). But in some studies with short follow up, CME has responded to bevacizumab with subsequent improvement in vision. Purpose: To study effects of bevacizumab in the resolution of CRVO. Materials and Methods: This case series included 32 patients presenting with CRVO having CME. An injection of 1.25 mg bevacizumab (Avastin) in 0.05 ml was given to all patients. Individual response to treatment was checked by best corrected visual acuity (BCVA), optical coherence tomography (OCT), fluorescein angiography, and tonometry and based on that re-injection was considered. Results: Follow-up was 4 months; mean number of injections was 2.2 (range, 2−3) per patient. Baseline central macular thickness was 665.25 (mean) +/- 187.63 µ. Statistically significant reduction of macular thickness (P < 0.001) was seen at six weeks (mean 280.37 +/- 93.31µ); 12 weeks (mean 305.12 +/- 54.26µ) and 16 weeks (mean 270.37 +/- 50.89µ). Significant BCVA improvement was seen at six weeks (mean, 6/60 Snellen), and 16 weeks (mean, 6/60 +/-2 Snellen) from baseline best corrected visual acuity (mean, 4/60). Also, 23 patients (71.85%) had BCVA improvement at the last follow-up. Conclusion: In CRVO patients, CME has shown positive response to intravitreal injection of bevacizumab.  Reinjections if given at appropriate time can result in better visual outcome. Keywords: Bevacizumab, central retinal vein occlusion, macular oedema