Evaluation of the Efficacy of Single Dose of Intravitreal Bevacizumab in the Management of Macular Edema due to Retinal Vein Occlusions

Abstract

Aim: Evaluation of the efficacy of single-dose intravitreal Bevacizumab in the management of macular edema due to retinal vein occlusions. Objectives: 1. To evaluate the efficacy of single-dose intravitreal bevacizumab in the management of macular edema due to retinal vein occlusions in terms of reduction in central macular thickness. 2. To evaluate the efficacy single dose of intravitreal bevacizumab in the management of macular edema due to retinal vein occlusions in terms of improvement in visual acuity. 3. To evaluate the change in the Intraocular pressure in the eyes receiving intravitreal Bevacizumab. Methods: This study was an Institutional Review Board approved prospective interventional study done in a Retina clinic at a tertiary eye hospital, where 45 patients were enrolled. All patients clinically diagnosed to have retinal vein occlusions with macular edema with all risk factors were enrolled for the study. After informed consent, all participants were subjected to the following examinations, visual acuity was recorded on Snellen's vision chart, followed by anterior segment evaluation, intraocular pressure, gonioscopy, slit-lamp biomicroscopy with 90D lens and fundus finding were confirmed by indirect ophthalmoscopy. Optical coherence tomography was done in every patient. The diagnosis of macular edema was established by clinical examination and optical coherence tomography was done to quantify central macular thickness (CMT) at baseline, 4 weeks and 8 weeks after a single injection of 1.25 mg (0.05 ml) intravitreal Bevacizumab. Results: The mean central macular thickness (CMT) at presentation was 482.88 µm ± 173.6 µm (SD). The mean CMT decreased from baseline to 314.3 µm ± 129.9 µm at one month. The mean CMT decreased to 237.1 µm ± 97.08 µm at the end of 2 months which was statistically significant (p < 0.05). The logarithm of minimal angle of resolution (logMAR) vision at presentation 1.043 ± 0.443 improved to 0.690 ± 0.424 and 0.529 ± 0.440 at 1 month and 2 months respectively (p < 0.05). There was no statistically insignificant change in IOP after a single injection of Bevacizumab. Conclusion: Intravitreal Bevacizumab even in a single dose is effective in the treatment of all types of retinal vein occlusions. There was a statistically significant improvement in visual acuity, the decrease in the central macular thickness was also statistically significant and effects were maintained throughout the follow-up period without any changes in IOP.