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Moon, Kim, Kim, Kang, and Yoon: Intravitreal Bevacizumab for Macular Edema Secondary to Ruptured Retinal Arterial Macroaneurysm
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(4): 522-527.

Published online: 17 April 2012

DOI: https://doi.org/10.3341/jkos.2012.53.4.522

Intravitreal Bevacizumab for Macular Edema Secondary to Ruptured Retinal Arterial Macroaneurysm

Sang Jeong Moon, MD1, Sang Won Kim, MD1, Ho Soong Kim, MD2, Jae Hoon Kang, MD3, Hee Seong Yoon, MD1

1Sungmo Eye Hospital, Busan, Korea.

2Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.

3Woojung Eye Clinic, Ulsan, Korea.

Address reprint requests to Hee Seong Yoon, MD. Sungmo Eye Hospital, #409-1 Haeundae-ro, Haeundae-gu, Busan 612-823, Korea. Tel: 82-51-743-0775, Fax: 82-51-743-0776, heesyoon@dreamwiz.com

Received 8 March 2011       Accepted 7 March 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To study the short-term effect of intravitreal injection of bevacizumab in the treatment of macular edema secondary to retinal macroaneurysm.

Methods

Eight eyes of 9 patients who underwent consecutive intravitreal bevacizumab injections for macular edema secondary to retinal macroaneurysm were prospectively evaluated. Complete eye examination including the best corrected visual acuity (BCVA), fundus examination and optical coherence tomography (OCT) were performed at baseline and follow-up visits at 2, 4 and 6 months.

Results

The mean age was 73.6 ± 6.9 years, and the mean study period was 7.3 ± 2.6 months. At the final visit, BCVA improved from log MAR 1.92 ± 0.67 to log MAR 0.87 ± 0.57. The mean central macular thickness on OCT image decreased from 388 ± 168 µm at the initial visit to 200 ± 39 µm at the final visit. Three eyes without subretinal hemorrhage presented better visual outcome than eyes with subretinal hemorrhage. All eyes showed some decrease in angiographic leakage. No adverse side effects were observed following the injections.

Conclusions

Intravitreal bevacizumab injection can be used as a selective alternative treatment modality for macular edema secondary to retinal macroaneurysm.

Keywords: Bevacizumab, Retinal macroaneurysm

Figures and Tables

Figure 1
(A) The fundus photograph of case 1 at pre-injection of bevacizumab shows the edematous macula, retinal and subretinal hemorrhage, exudates at the posterior pole, associated a macroaneurysm in the supratemporal artery in his right eye. (B) The optical coherence tomography (OCT) image at pre-injection demonstrated a lot of subretinal serous fluid. (C, D) The fundus photograph and OCT image at 4 months after bevacizumab injection showed subretinal serous fluid, preretinal and subretinal hemorrhage were absorbed completely and small retinal hard exudates increased slightly.
jkos-53-522-g001
Figure 2
(A, B) At pre-injection, the fundus photograph and optical coherence image of case 3 demonstrats mild, superficial retinal hemorrhages are situated along a ruptured arterial macroaneurysm and macula was edematous with serous subretinal fluid collection. (C, D) The images at 2 months after bevacizumab treatment shows retinal hemorrhage and macula edema were improved, but some exudates are seen at macular area.
jkos-53-522-g002
Table 1
Characteristics of patient with the retinal arterial macroaneurysm and macular edema
jkos-53-522-i001

PRH = preretinal hemorrhage; SRH = subretinal hemorrhage; IRH = intraretinal hemorrhage; VH = vitreous hemorrhage.

Table 2
Comparison of baseline and final best corrected visual acuity and central macular thickness
jkos-53-522-i002

Values are presented as mean ± SD.

*p < 0.05.

Table 3
Comparison of baseline and final best corrective visual acuity and central macular thickness according to macular subretinal hemorrhage
jkos-53-522-i003

Values are presented as mean ± SD.

BCVA = best corrected visual acuity; CMT = central macular thickness.

*Mann Whitney test; †p < 0.05.

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