Results of Intravitreal Bevacizumab for Macular Edema with Retinal Vein Occlusion and Diabetic Macular Edema

Jong Youn Kim; Eui Yong Kweon; Dong Wook Lee; Nam Chun Cho

doi:10.3341/jkos.2008.49.8.1275

Journal List > J Korean Ophthalmol Soc > v.49(8) > 1008048

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Kim, Kweon, Lee, and Cho: Results of Intravitreal Bevacizumab for Macular Edema with Retinal Vein Occlusion and Diabetic Macular Edema

Original Article

J Korean Ophthalmol Soc 2008;49(8):1275-1282.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.8.1275

Results of Intravitreal Bevacizumab for Macular Edema with Retinal Vein Occlusion and Diabetic Macular Edema

Jong Youn Kim, M.D., Eui Yong Kweon, M.D., Dong Wook Lee, M.D., Nam Chun Cho, M.D.

Department of Ophthalmology, Chonbuk National University, School of Medicine, Jeonju, Korea

Address reprint requests to Eui Yong Kweon, M.D. Department of Ophthalmology, Chonbuk National University, School of Medicine #634-18 Geumam-dong, Dukjin-gu, Jeonju, Jeonbuk 560-182, Korea Tel: 82-63-250-1965, Fax: 82-63-250-1960, E-mail: key@chonbuk.ac.kr

Received 23 April 2008 Accepted 3 January 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the short-term effect and safety of intravitreally injected bevacizumab in patients with macular edema (ME) caused by retinal vein occlusion (RVO) and diabetic macular edema (DME).

Methods

We retrospectively evaluated 59 eyes of 51 patients, 29 with ME caused by RVO and 30 with DME, who received intravitreal injection of bevacizumab. Fifty-one consecutive patients (59 eyes) with ME associated with RVO and DME were treated with intravitreal injections of 1.25-2.5 mg (0.05-0.1 ml) of bevacizumab. Ophthalmic evaluation was performed at baseline and at 1, 3, 6 months after each injection. Clinical evidence of toxicity and complications, changes of visual acuity with an ETDRS chart (LogMAR), and central macular thickness (CMT) using optical coherence tomography (OCT), were evaluated.

Results

The follow-up period was 7.3 months (7.3±0.31) and the mean number of injections was 1.2. The baseline mean LogMAR was 1.06±0.53 and mean CMT was 479.6±160.4 µm. At 1, 3 and 6 months, the mean LogMAR was 0.90±0.52, 0.80±0.39 and 0.78±0.39, respectively, and the mean CMT was 316.9±86.7 µm, 281.1±67.4 µm and 278.4±64.6 µm, respectively. No adverse incidents were observed, including cataract, retinal detachment, vitreous hemorrhage, and endophthalmitis, although transient increased intraocular pressure was observed.

Conclusions

Intravitreal bevacizumab injections are safe and effective in ME caused by RVO and DME.

Keywords: Bevacizumab (Avastin ®), Macular edema, Vascular endothelial growth factor (VEGF)

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Figure 1.

Changes in LogMAR after intravitreal bevacizumab injections, according to macular edema etiology; DME=diabetic macular edema; ME=macular edema; RVO=retinal vein occlusion.

Figure 2.

Changes of central macular thickness with optical coherence tomography (OCT) after intravitreal bevacizumab injections. DME=diabetic macular edema; ME=macular edema; RVO= retinal vein occlusion.

Figure 3.

The relationship between visual acuity increase and macular thickness decrease (%) at 6 months after intravitreal bevacizumab injections.

Table 1.

Patients’ characteristics

Variable	Data
Age (years)
Mean±SD*	59.0±7.2
Range	30-79
Total (eyes, %)
Male	32 (54.2%)
Female	27 (45.8%)
Unerlying disease (%)
Diabetic retinopathy, Proliferative	17 (28.8%)
Diabetic retinopathy, Non-Proliferative	13 (22.0%)
CRVO^†	17 (28.8%)
BRVO^‡	12 (20.3%)
Follow up period (months)
Mean±SD*	7.3±0.31
Range	6-8
Preoperative BCVA^§ (LogMAR^＃, mean±SD*)	1.06±0.53
Preoperative central macular thickness (µm, mean±SD*)	479.6±160.4

^* SD=Standard deviation;

^† CRVO=Central retinal vein occlusion; corrected visual acuity;

^＃ LogMAR=Logarithm of the minimum angle of resolution.

^‡ BRVO=Branched retinal vein occlusion;

^§ BCVA=Best

Table 2.

The numbers of eyes, mean age, mean follow-up time, BCVA*, central macular thickness before intravitreal bevacizumab injection

	DME	RVO	BRVO	CRVO
Age (years)	57.9	61.5	65.4	57.5
Total (eyes)	30	29	12	17
Male	16	16	4	12
Female	14	13	8	5
Mean follow up time(months)	7.1	7.4	7.5	7.3
Preoperative BCVA*
(LogMAR^†,mean±SD^§)/	1.06±0.53 /	1.07±0.55 /	0.62±0.41/	1.38±0.4 /
CMT^‡(µm, mean±SD^§)	480.7±153.2	478.4±170.2	406.6±96.9	529.2±193.9

^* BCVA=best corrected visual acuity;

^† LogMAR=logarithm of the minimum angle of resolution; thickness;

^‡ CMT=central macular

^§ SD=standard deviation.

Table 3.

Changes in visual acuity and central retinal thickness in macular edema caused by diabetic macular edema(DME)

	Baseline	1 month	3 months	6 months
BCVA*	1.06±0.53	0.88±0.47	0.81±0.40	0.77±0.33
(LogMAR^†, mean±SD^＃)		(P=0.006)^§	(P<0.001)^§	(P<0.001)^§
CMT^‡	480.7±153.2	326.5±86.9	290±68.2	287.4±67.7
(µm, mean±SD^＃)		(P<0.001)^§	(P<0.001)^§	(P<0.001)^§

^* BCVA=best corrected visual acuity;

^† LogMAR=logarithm of the minimum angle of resolution;

^‡ CMT=central macular thickness;

^§ Paired t-test;

^＃ SD=standard deviation.

Table 4.

Changes in visual acuity and central retinal thickness in macular edema caused by retinal vein occlusion (RVO)

	Baseline	1 month	3 months	6 months
BCVA*	1.07±0.55	0.91±0.57	0.79±0.39	0.78±0.46
(LogMAR^†, mean±SD^＃)		(P=0.002)^§	(P=0.006)^§	(P=0.001)^§
CMT^‡	478.4±170.2	307.1±86.8	271.9±66.4	269.1±60.9
(µm, mean±SD^＃)		(P<0.001)^§	(P<0.001)^§	(P<0.001)^§

^* BCVA=best corrected visual acuity;

^† LogMAR=logarithm of the minimum angle of resolution;

^‡ CMT=central macular thickness;

^§ Paired t-test;

^＃ SD=standard deviation.

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