Yonsei Med J.  2017 May;58(3):676-678. 10.3349/ymj.2017.58.3.676.

Angiographically Documented Macular Ischemia after Single Bevacizumab for Macular Edema Secondary to Central Retinal Vein Occlusion

• Lee KH
• Kang EC
• Koh HJ

• KMID: 2419132
• DOI: http://doi.org/10.3349/ymj.2017.58.3.676

Abstract

This report describes a case of angiographically documented foveal avascular zone (FAZ) enlargement after a single intravitreal injection of bevacizumab for macular edema secondary to central retinal vein occlusion (CRVO). A 71-year-old female was treated with an intravitreal bevacizumab injection for macular edema following CRVO. Despite successfully decreased edema one month after injection, the postinjection best-corrected visual acuity immediately decreased from 20/40 to 20/1000 (Snellen equivalent). The FAZ area increased from 0.37 mm² to 3.11 mm² (8.4-fold increase). While intravitreal anti-vascular endothelial growth factor is effective and should be considered as a first-line treatment for macular edema secondary to CRVO, it may aggravate macular ischemia.

Keyword

Macular edema; central retinal vein; fovea centralis; bevacizumab; fluorescein angiography

MeSH Terms

Aged
Angiogenesis Inhibitors/*administration & dosage
Antibodies, Monoclonal/therapeutic use
Antibodies, Monoclonal, Humanized/therapeutic use
Bevacizumab/*administration & dosage/adverse effects
Female
Fluorescein Angiography
Humans
Intravitreal Injections
Macular Edema/diagnosis/*drug therapy/etiology
Male
Middle Aged
Retina/*drug effects/pathology/physiopathology
Retinal Vein Occlusion/*complications/diagnosis/*drug therapy
Tomography, Optical Coherence
Treatment Outcome
Vascular Endothelial Growth Factor A/immunology
Visual Acuity/physiology
Vitreous Body
Angiogenesis Inhibitors
Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Vascular Endothelial Growth Factor A
Bevacizumab

Figure

• 

  Fig. 1 Fundus photography and fluorescein angiography, before (A and C) and one month after intravitreal bevacizumab injection (B and D). The macular edema resolved after a single intravitreal injection of 1.25 mg of bevacizumab. However, the foveal avascular zone area increased from 0.37 mm2 to 3.11 mm2, and best-corrected visual acuity decreased from 20/40 to 20/1000 (Snellen equivalent).

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