Abstract

P 259

Effect of intravitreal Bevacizumab (Avastin^®) in patients with clinical significant macular edema due to central vein occlusion

Lepper S., Einbock W., Sarra G.-M., Fleischhauer J., Wolf S., Wolf- Schnurrbusch U.
Klinik und Poliklinik für Augenheilkunde, Inselspital, Universität Bern, Bern

Objective: We undertook the investigation to retrospectively quantify the functional and morphological changes on macular edema after central vein occlusion (CVO) and a intravitreal therapy (IVT) with the monoclonal antibody Bevacicumab (Avastin^®).
Methods: We included 18 eyes from 18 consecutive patients in our retrospective analysis. In 7 cases (eyes) we found a ischemic and in 11 cases a non-ischemic CVO. In 10 patients (56%) hemodilution was performed. Intravitreal therapy with bevazizumab was initiated 2-192 weeks (mean±SD: 27±47) after CVO. We evaluated retinal thickness using optical coherence tomography (OCT) and acuity of vision using best-corrected vision (Snellen Charts) before and after intravitreal bevazizumab-injection.
Results: In individual patients 1-7 (mean: 2,6±1,6) IVTs were performed. Mean acuity of vision at baseline was 0,89±0,5 LogMAR (decimal: 0,22, with a range of 0,015-0,6). At the final consultation of the patients acuity of vision was 0,73±0,45 LogMAR (decimal: 0,28, ranging from 0,025-1,0). Severe adverse systemic effects were not observed. Mean follow-up was 18±11 weeks (range 2- 40). In 6 eyes a loss of vision was observed and in 12 eyes we noticed a stabilisation or gain of function. Mean central retinal thickness was 487±164 μm (188-766 μm) at baseline and was statistically significant (p<0.05) reduced due to IVT to 375±136 μm (185-684 μm).
Conclusions: In 12 patients a stabilisation or gain of function could be achieved, however in 2 cases we noted a severe loss of vision despite IVT. Further we observed a statistically significant reduction of central retinal thickness (OCT). Our results point to a significant reduction of capillary leakage and macular edema as a consequence of IVT with bevazizumab in case of CVO. Bevazizumab thus represents a feasible alternative for therapy of cystoid macular edema after CVO.

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