Intravitreal Bevacizumab for Treatment of Macular Edema Secondary to Central Retinal Vein Occlusion: Eighteen-Month Results of a Prospective Trial

“…Ranibizumab, a humanized, affinity-matured antibody fragment against all isoforms of VEGF-A, has been shown in the CRUISE trial 4 to provide rapid improvement in visual acuity (VA) and MO after CRVO. Studies have also demonstrated positive results with the use of bevacizumab, 5,6 the parent molecule of ranibizumab, which has been used off-label as a cost-effective alternative to ranibizumab. Anti-VEGF agents are associated with a more favorable safety profile compared with intravitreal steroids with respect to intraocular pressure and cataract, and thus are first-line treatment for MO due to CRVO by most retina specialists.…”

Section: Introductionmentioning

confidence: 99%

Intravitreal aflibercept for macular oedema secondary to central retinal vein occlusion in patients with prior treatment with bevacizumab or ranibizumab

Papakostas

Lim

Zyl

et al. 2015

Eye

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Purpose To report the visual and anatomic outcomes in eyes with macular oedema (MO) secondary to central retinal vein occlusion (CRVO) that were switched from either intravitreal bevacizumab or ranibizumab to intravitreal aflibercept. Methods Two-center retrospective chart review. Eyes with MO secondary to CRVO that received a minimum of three intravitreal injections of bevacizumab or ranibizumab and were switched to intravitreal aflibercept for persistent or recurrent MO not responding to either bevacizumab and/or ranibizumab. Results In all 42 eyes of 42 patients were included in the study. The median visual acuity before the switch was 20/126, 1 month after the first injection of aflibercept 20/89 (P = 0.0191), and at the end of the follow-up 20/100 (P = 0.2724). The median CRT before the switch was 536 μm, 1 month after the first injection of aflibercept 293.5 μm (P = 0.0038), and at the end of the follow-up 279 μm (P = 0.0013 compared to before the switch). The median number of weeks between injections before the switch was 5.6 and after the switch was 7.6 (Po0.0001). Conclusion Converting eyes with refractory MO due to CRVO to aflibercept can result in stabilization of the vision, improved macular anatomy, and extension of the injection interval.

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“…; Zhang et al. ; Epstein et al. ) However, the authors mostly suggested repeated injections of these drugs for maintaining visual acuity (VA) improvement.…”

Section: Introductionmentioning

confidence: 99%

Three intravitreal bevacizumab versus two intravitreal triamcinolone injections in recent onset central retinal vein occlusion

Ramezani

Esfandiari

Entezari

et al. 2013

Acta Ophthalmologica

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ABSTRACT.Purpose: To evaluate the effects of repeated intravitreal injections of bevacizumab (IVB) versus triamcinolone acetonide (IVT) in the treatment of acute central retinal vein occlusion (CRVO). Methods: In this randomized clinical trial, 86 eyes with recent onset (<12 weeks) CRVO were assigned to two groups: IVB group (43 eyes) that received three monthly injections of 1.25 mg of IVB, and IVT group (43 eyes) that received two injections of 2 mg IVT 2 months apart. Outcomes were best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP) changes. Results: Mean BCVA improved significantly at 6 months in both groups; from 0.87 AE 0.49 to 0.41 AE 0.35 logMAR in IVB group, and from 0.81 AE 0.45 to 0.62 AE 0.48 logMAR in IVT group (p < 0.001). However, between-group differences reach a significant level at months 4 (p = 0.003) and 6 (p < 0.001) in favour of the IVB group. In terms of CMT reduction, the difference between the groups was statistically significant (p = 0.002) at month 6. Significant differences were noted more in the ischaemic cases in favour of the IVB group. Mean IOP rise was significantly higher in the IVT group at all visits. Conclusions: Both 3-times monthly IVB injections and 2-times IVT injections could be effective in cases with recent onset CRVO up to 6 months. However, considering the better outcomes after IVB injections and the potential complications of IVT injections, we would recommend prescheduled repeated IVB injections for such cases. The observed favourable responses were more pronounced in the ischaemic types; nevertheless, this should be confirmed in larger studies.

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Intravitreal Bevacizumab for Treatment of Macular Edema Secondary to Central Retinal Vein Occlusion: Eighteen-Month Results of a Prospective Trial

Abstract: Intravitreal bevacizumab is generally well tolerated and may improve VA and decrease CRT in patients with macular edema secondary to CRVO over a period of 18 months.

Cited by 32 publications

References 31 publications

Bevacizumab treatment of macular edema in CRVO and BRVO: long-term follow-up. (BERVOLT study: Bevacizumab for RVO long-term follow-up)

Bevacizumab treatment of macular edema in CRVO and BRVO: long-term follow-up. (BERVOLT study: Bevacizumab for RVO long-term follow-up)

Intravitreal aflibercept for macular oedema secondary to central retinal vein occlusion in patients with prior treatment with bevacizumab or ranibizumab

Three intravitreal bevacizumab versus two intravitreal triamcinolone injections in recent onset central retinal vein occlusion

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