MAY 16, 2008
This is a small prospective, nonrandomized study that has demonstrated some benefit to giving intravitreal Avastin injections to patients with branch retinal vein occlusion (BRVO) and macular edema but no benefit in patients with central retinal vein occlusion (CRVO) and macular edema.
Study subjects were 28 consecutive patients and 29 eyes, of which 21 eyes had BRVO and eight CRVO. The study protocol called for subjects to receive intravitreal Avastin injections three times at four-week intervals and further treatment over the six-month study period if optical coherence tomography (OCT) indicated persistent or recurrent intraretinal edema. The eyes with BRVO received a mean of 5.5 out of a possible seven injections and showed a statistically significant improvement in best corrected visual acuity and central retinal thickness as measured by OCT after six months. Eyes with CRVO received a mean of 4.8 injections but did not experience significant improvements in visual acuity or central retinal thickness.
Eyes with BRVO and macular edema did require frequent injections to maintain their improvement up to the end of the study period. It was also noted that patients with a longer duration of BRVO and edema experienced less improvement, as indicated by gains seen in OCT results but not visual acuity.
The study's limitations include the small number of study subjects, very small number of eyes with CRVO, and lack of a comparison between intravitreal Avastin and focal laser treatment for eyes with BRVO, which probably would have been the best way to demonstrate the overall benefits of intravitreal Avastin.
Dr. Flaxel has no financial relationships to disclose.