J Korean Ophthalmol Soc.  2011 Oct;52(10):1202-1207. 10.3341/jkos.2011.52.10.1202.

Clinical Course after Intravitreal Bevacizumab Injection in Ischemic Central Retinal Vein Obstruction

• Yoo ES
• Lew YJ
• Choi MJ
• Han JI
• Yoo SJ
• Lee DW
• Cho SW
• Kim CG
• Lee TG
• Kim JW
• Lee JH

• KMID: 2215003
• DOI: http://doi.org/10.3341/jkos.2011.52.10.1202

Abstract

PURPOSE
To determine the clinical outcome of intravitreal bevacizumab injection in patients with ischemic central retinal vein obstruction (CRVO).
METHODS
The present study was conducted retrospectively on 56 eyes of 56 patients who were diagnosed with CRVO and classified according to ischemic and non-ischemic type and underwent an intravitreal bevacizumab injection. The present study measured changes in visual acuity and central macular thickness, neovascularization in the anterior segment, development of neovascular glaucoma and other clinical complications.
RESULTS
The average number of bevacizumab injections in both groups was 2.07 and 1.62 in the ischemic type. No patients developed neovascular glaucoma in the non-ischemic type group, 14 of 26 eyes in the ischemic type group developed neovascular glaucoma and the mean time to diagnosis was 28.75 weeks. log MAR visual acuity of the ischemic type group prior to injection was 1.56 +/- 0.65 on average which improved to 1.44 +/- 0.97 (p = 0.45).
CONCLUSIONS
Intravitreal bevacizumab injection improves the condition of cystic macular edema clinically, but does not affect the development of neovascular glaucoma and improvement of visual acuity in ischemic type CRVO.

Keyword

Central retinal vein obstruction; Intravitreal bevacizumab injection; Neovacular glaucoma

MeSH Terms

Antibodies, Monoclonal, Humanized
Eye
Glaucoma, Neovascular
Humans
Macular Edema
Retinal Vein
Retrospective Studies
Visual Acuity
Bevacizumab
Antibodies, Monoclonal, Humanized

Figure

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  Figure 1. A 52 year old man visited our clinic for visual disturbance. Best corrected visual acuity was 0.9 log MAR scale. FAG in the arterial and venous phase showed extensive hypoperfusion and blocked fluorescence at the post pole (A, B), and hypoperfusion with diffuse leakage in the late phase (C). Fundus photograph (D) showed multiple retinal hemorrhage and cotton wool spots along the major vascular arcade, OCT (E) showed diffuse cystoid macular edema before intravitreal bevacizumab injection (CMT: 522 μ m). 6 months after the injection, fundus photograph (F) showed that retinal hemorrhage and cotton wool spots had decreased, OCT (G) showed decreased macular edema after intravitreal bevacizumab injection (CMT: 174 μ m).

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  Figure 2. This diagram shows the occurrence of neovascular glaucoma (NVG) in patients of ischemic central retinal vein obstruction, mean duration of neovascular glaucoma was 28.75 weeks, Ahmed valve implantation and panretinal photocoagulation was performed on 1 patient and 8 patients respectively.

Reference

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