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Lee, Song, and Park: Bevacizumab Therapy for Branch Retinal Vein Occlusion Associated with Normal Tension Glaucoma
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(5): 632-638.

Published online: 16 May 2012

DOI: https://doi.org/10.3341/jkos.2012.53.5.632

Bevacizumab Therapy for Branch Retinal Vein Occlusion Associated with Normal Tension Glaucoma

Kwang Hoon Lee, MD1, Young Bin Song, MD2, Sung Pyo Park, MD, PhD2

1Department of Ophthalmology, Happyeye21 Clinic, Gwangju, Korea.

2Department of Ophthalmology, Kangdong Sacred Heart Hospital Hallym University College of Medicine, Seoul, Korea.

Address reprint requests to Sung Pyo Park, MD, PhD. Department of Ophthalmology, Hallym University Kangdong Sacred Heart Hospital, #150 Seongan-ro, Gangdong-gu, Seoul 134-701, Korea. Tel: 82-2-2224-2274, Fax: 82-2-470-2088, sungpyo@hanafos.com

Received 16 March 2011       Accepted 7 April 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To evaluate the therapeutic efficacy of intravitreal bevacizumab (IVB) in the treatment of branch retinal vein occlusion (BRVO) in eyes with normal tension glaucoma (NTG).

Methods

We included 16 NTG eyes and 48 age- and sex-matched eyes without NTG that had received IVB for BRVO with more than 6 months of follow-up. The main outcome measures were log MAR best-corrected visual acuity (BCVA) and central macular thickness (CMT) at baseline and 1, 3, and 6 months after IVB. We compared the results according to the comorbidity associated with NTG.

Results

The obstruction site of BRVO was significantly closer to the optic disc in eyes with NTG than in eyes without NTG. Baseline log MAR BCVA and CMT were similar between the two groups. After IVB, postoperative BCVA was significantly improved and CMT was significantly reduced, irrespective of the comorbidity associated with NTG. However, vision improvement was more limited in eyes with NTG, while CMT was similarly reduced compared with that in eyes without NTG. The mean numbers of injections were similar between the two groups, and there were no injection-related complications.

Conclusions

IVB may have therapeutic efficacy in the treatment of BRVO associated with NTG. However, the comorbidity associated with NTG may limit vision improvement, although anatomic recovery of CMT is achieved.

Keywords: Branch retinal vein occlusion, Intravitreal bevacizumab, Macular edema, Normal tension glaucoma

Figures and Tables

Figure 1
Fundus and red-free photographs of a branch retinal vein occlusion (BRVO) patient (A, B), who had been diagnosed with normal tension glaucoma based on glaucomatous optic disc and visual field defect correspond with inferior diffuse retinal nerve fiber layer defect before the onset of BRVO (C, D). M acular edema improved after invtravitreal bevacizumab (IVB) therapy on optical coherence tomography at baseline and post IVB therapy 1, 3, 6 months, respectively (E, F, G, H).
jkos-53-632-g001
Figure 2
Changes in log MAR visual acuity after bevacizumab therapy for macular edema secondary to branch retinal vein occlusion. NTG = normal tension glaucoma.
jkos-53-632-g002
Figure 3
Changes in central macular thickness after bevacizumab therapy for macular edema secondary to branch retinal vein occlusion. NTG = normal tension glaucoma.
jkos-53-632-g003
Table 1
Baseline clinical features of patients receiving intravitreal injection of bevacizumab for macular edema secondary to branch retinal vein occlusion (BRVO) with or without normal tension glaucoma (NTG)
jkos-53-632-i001

Values are presented as number or mean ± SD.

R = right; L = left; S = superior; I = inferior; M = macular; CMT = central macular thickness; BCVA = best-corrected visual acuity.

*Indicates the frequencies of obstruction sites of BRVO that are divided into two patterns. ONH indicates that the obstruction site is located within 500 µm from the optic disc. AV indicates that the obstruction site is located at the arteriovenous crossing site.

Table 2
Changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) after intravitreal injection of bevacizumab for macular edema secondary to branch retinal vein occlusion (BRVO) associated with or without normal tension glaucoma (NTG)
jkos-53-632-i002

Values are presented as mean ± SD.

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

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