Evaluation of early versus late intravitreal bevacizumab injection in the treatment of macular edema secondary to branch retinal vein occlusion

• Main Author: Hesham A Enany
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Delta Journal of Ophthalmology
• Subjects: bevacizumab; branch retinal vein occlusion; intravitreal; macular edema; retina
• Online Access: http://www.djo.eg.net/article.asp?issn=1110-9173;year=2018;volume=19;issue=1;spage=58;epage=64;aulast=Enany

Purpose The aim of this study was to evaluate the efficacy and safety of early versus late use of bevacizumab (Avastin) as an intravitreal injection in cases with branch retinal vein occlusion (BRVO). Patients and methods Twenty patients with BRVO with macular edema were divided according to the time elapsed between presentation and the onset of the vascular event into two groups: group I included 10 patients presenting within 3 months of BRVO and group II included 10 patients with BRVO presenting after 3 months of the vascular event. Patients in both groups received three intravitreal injections of bevacizumab. The first injection was administered at presentation, and then monthly for two additional doses. Results Foveal thickness measured by optical coherence tomography in µm decreased significantly after the intravitreal bevacizumab injection in group I from 451.5±57.9 to 428.1±59.5 after 1 month, to 369.5±52.6 after 3 months, and to 342.4±41.1 after 6 months, whereas in group II, the foveal thickness was reduced from 440.3±75.5 to 437.3±70.3 after 1 month, to 419.1±63.1 after 3 months, and to 380.1+69.4 after 6 months, a statistically insignificant difference. Best-corrected visual acuity in log MAR at baseline in group I was 0.84+0.2 and improved to 0.74+0.19 at 1 month, 0.74+0.25 at 3 months, and 0.72+0.15 after 6 months, whereas in group II, BCVA in log Mar at baseline was 0.75+0.2 and improved after 1 month of intravitreal bevacizumab injection to 0.74±0.26, to 0.74±0.27 after 3 months, and to 0.70±0.27 after 6 months. Conclusion The study showed improved visual acuity following treatment of BRVO-associated macular edema with bevacizumab intravitreal injections. The benefit was greater in the patients who received the first injection early in the course of the disease and in patients in whom three injections were administered.