Predictive factors for changes in macular edema in intravitreal bevacizumab therapy of retinal vein occlusion

• Verfasst von: Ach, Thomas [VerfasserIn]
• Verfasst von: Höh, Alexandra E. [VerfasserIn]
• Verfasst von: Schaal, Karen B. [VerfasserIn]
• Verfasst von: Scheuerle, Alexander F. [VerfasserIn]
• Verfasst von: Dithmar, Stefan [VerfasserIn]
• Titel: Predictive factors for changes in macular edema in intravitreal bevacizumab therapy of retinal vein occlusion
• Verf.angabe: Thomas Ach, Alexandra E. Hoeh, Karen B. Schaal, Alexander F. Scheuerle, Stefan Dithmar
• Jahr: 2010
• Umfang: 5 S.
• Fussnoten: Online veröffentlicht: 9 September 2009 ; Gesehen am 15.11.2022
• Titel Quelle: Enthalten in: Graefe's archive for clinical and experimental ophthalmology
• Ort Quelle: Berlin : Springer, 1854
• Jahr Quelle: 2010
• Band/Heft Quelle: 248(2010), Seite 155-159
• ISSN Quelle: 1435-702X
• DOI: doi:10.1007/s00417-009-1167-6
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Bevacizumab
• Sach-SW: Intravitreal injection
• Sach-SW: Macular edema
• Sach-SW: Prognostic factor
• Sach-SW: Retinal vein occlusion
• Sach-SW: VEGF
• K10plus-PPN: 1822516005

Abstract

Background: To evaluate prognostic factors of response to intravitreal bevacizumab therapy of macular edema (ME) due to central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO). Methods: Patients with ME due to CRVO (32 patients) or BRVO (38 patients) received intravitreal bevacizumab (2.5 mg/0.1 ml) at baseline, and every 6 to 8 weeks if OCT showed persistent or recurrent ME. Visual acuity (EDTRS), ophthalmic examination and OCT were performed at baseline and at all follow-up visits. Six to 8 weeks after first injection, baseline factors (visual acuity, central retinal thickness, age and gender) were analyzed retrospectively between patients with resolved ME (group 1) and persisting ME (group 2). At last visit, baseline factors of patients with resolved ME since first injection (group A), with recurrent ME since baseline (group B) and with persistent ME since baseline (group C) were compared. Results: In CRVO patients, central retinal thickness (CRT) and patients’ age are prognostic predictors in bevacizumab therapy. Age of CRVO patients differed significantly between groups 1 and 2 after first injection, while CRT only showed a strong trend to thinner CRT. At last visit, age and CRT differed statistically significantly between groups A, B and C. In BRVO patients, none of the investigated factors revealed any prognostic value. In CRVO and BRVO patients, final CRT is correlated with the CRT after first injection. Conclusion: CRT and age of patients have prognostic value in bevacizumab therapy of ME due to CRVO. CRVO patients who benefit from therapy are significantly younger and have a lower CRT at baseline than patients with persisting ME. In BRVO patients, no predictive factors for effectiveness of bevacizumab therapy could be observed. Introduction: Central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) are common vascular retinal disorders. Loss of visual function due to CRVO or BRVO is mainly caused by macular edema (ME). Treatment strategies for ME comprise laser treatment (BRVO), intravitreal steroids, surgical procedures [1–5] and, most recently, off-label intravitreal injection of anti-VEGF agents. There is increasing evidence that intravitreal injection of bevacizumab can lead to significant reduction of ME [6–8]. However, treatment success is often temporary, and in some patients bevacizumab therapy is not effective, despite multiple intravitreal injections. It is still unclear whether there are any prognostic factors that can predict the success of bevacizumab therapy. The aim of this study was to evaluate prognostic baseline factors for intravitreal bevacizumab therapy of ME due to retinal vein occlusion. Patients and methods: In this retrospective study, 70 patients (32 CRVO, 38 BRVO) with ME due to retinal vein occlusion were treated with at least one intravitreal injection of 2.5 mg bevacizumab. Patients’ baseline data are shown in Table 1. Patients were only included if they had not received any previous treatment. Informed written consent was obtained from every patient, with special note to the off-label use. All procedures conformed to the tenets of the Declaration of Helsinki.