Intravitreal bevacizumab in macular edema secondary to branch retinal vein occlusion: 12-month results

Raba Thapa,¹ Nhukesh Maharjan,² Govinda Paudyal<sup>1

1</sup>Vitreo-retinal Service, Tilganga Institute of Ophthalmology, ²Research Department, Tilganga Institute of Ophthalmology, Kathmandu, Nepal

Purpose: The purpose of this study was to evaluate the long-term safety, anatomical, and visual outcomes following intravitreal bevacizumab (Avastin; Genentech) on macular edema (ME) secondary to branch retinal vein occlusion (BRVO).
Methods: A prospective, interventional case series study was conducted among patients with ME due to BRVO, from June 2008 to October 2011. Intravitreal bevacizumab (1.25 mg/0.05 mL) was given at 4–6 weekly intervals until the ME subsided, and cases were followed up for a year. Complete ophthalmic evaluations and measurement of central retinal thickness (CRT) by optical coherence tomography were performed at baseline and follow-up visits.
Results: Sixty-three eyes of 63 patients were included in the study. The mean age was 58.22 years (standard deviation [SD], 12.3). The CRT at baseline was 515.3 ± 189.4 µm, and it significantly improved at each follow-up, with a CRT of 233.6 ± 101.5 µm at 12 months. The best-corrected visual acuity (BCVA) at baseline was 0.82 ± 0.54, and it significantly improved at each follow-up, with a BCVA of 0.40 ± 0.25 at 12 months (P < 0.001). The BCVA was better in 76% of the patients with a more than three-line increase in 55.5% of the eyes. The average number of intravitreal bevacizumab injections was 3.1 (range, 1–6 injections). Recurrent ME occurred in 30.2% of cases. There were no major ocular or systemic adverse events.
Conclusion: Intravitreal bevacizumab appears to be a safe and effective drug for reducing ME and improving visual acuity secondary to BRVO at 12-month follow-up at a tertiary referral eye hospital in Nepal.

Keywords: branch retinal vein occlusion, bevacizumab, macular edema