Intravitreal Bevacizumab for Refractory Pseudophakic Cystoid Macular Edema: The Pan-American Collaborative Retina Study Group Results
Presented in part at: American Academy of Ophthalmology Annual Meeting, November 2008, Atlanta, Georgia.
Received 25 September 2008; received in revised form 21 February 2009; accepted 1 April 2009. published online 22 June 2009.
Objective
To determine the feasibility, safety, and clinical effect of intravitreal (IVT) bevacizumab (Avastin; Genentech, Inc., San Francisco, CA) in patients with refractory cystoid macular edema (CME) after cataract surgery.
Design
Interventional, retrospective, multicenter study.
Participants
Thirty-six eyes of 31 patients with refractory CME after cataract surgery and with a mean age of 68.2 years (range, 67–87 years).
Methods
Patients were treated with at least 1 IVT injection of 1.25 or 2.5 mg bevacizumab. Patients were followed up for 12 months.
Main Outcome Measures
Best-corrected visual acuity (BCVA) and central macular thickness (CMT) by optical coherence tomography (OCT).
Results
Twenty-six eyes (72.2%) demonstrated improvement of BCVA (≥2 Early Treatment Diabetic Retinopathy Study [ETDRS] lines), and no eye experienced worsening of visual acuity (≥2 ETDRS lines). Mean baseline BCVA was 20/200 (0.96 logarithm of the minimum angle of resolution [logMAR] units), and the mean 12-month BCVA was 20/80 (0.62 logMAR units; P<0.0001). Optical coherence tomography demonstrated that mean CMT at baseline was 499.9 μm (range, 298–784 μm) and decreased to a mean of 286.1 μm (range, 168–499 μm) at 12 months (P<0.0001). Four (11%) eyes received 2 injections, 10 (27.8%) eyes received 3 injections, 10 (27.8%) eyes received 4 injections, 1 (2.8%) eye received 5 injections, and 1 (2.8%) eye received 6 injections. The mean number of injections was 2.7 (range, 1–6), and the mean interval between injections was 15.1 weeks (range, 4–45 weeks). No ocular or systemic adverse events were observed.
Conclusions
Short-term results suggest that IVT bevacizumab is well tolerated in patients with refractory pseudophakic CME. Treated eyes had a significant improvement in BCVA and decrease in macular thickness by OCT at 12 months.
Financial Disclosure(s)
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Available online: June 21, 2009.
1Retina and Vitreous Service, Clinica Oftalmológica Centro Caracas, Caracas, Venezuela
2Departamento de Oftalmologia, Instituto da Visão, Universidade Federal de São Paulo, São Paulo, Brazil
4Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico
5Retina and Vitreous Service, Instituto de Cirugia Ocular, San Jose, Costa Rica
Correspondence: J. Fernando Arevalo, MD, FACS, Clinica Oftalmológica Centro Caracas, Edif. Centro Caracas PH-1, Av. Panteon, San Bernardino, Caracas 1010, Venezuela
ABSTRACT