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

  • Retinal Disorders
  • Published:
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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.

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References

  1. Central Vein Occlusion Study Group (1993) Central vein occlusion study of photocoagulation therapy. Baseline findings. Central Vein Occlusion Study Group. Online J Curr Clin Trials Doc No 95

  2. Berker N, Batman C (2008) Surgical treatment of central retinal vein occlusion. Acta Ophthalmol 86:245–252

    Article  PubMed  Google Scholar 

  3. Hoh AE, Schaal KB, Dithmar S (2007) Central and branch retinal vein occlusion. Current strategies for treatment in Germany, Austria and Switzerland. Ophthalmologe 104:290–294

    Article  CAS  PubMed  Google Scholar 

  4. Jonas JB, Akkoyun I, Kamppeter B, Kreissig I, Degenring RF (2005) Intravitreal triamcinolone acetonide for treatment of central retinal vein occlusion. Eur J Ophthalmol 15:751–758

    CAS  PubMed  Google Scholar 

  5. Klein ML, Finkelstein D (1989) Macular grid photocoagulation for macular edema in central retinal vein occlusion. Arch Ophthalmol 107:1297–1302

    CAS  PubMed  Google Scholar 

  6. Badala F (2008) The treatment of branch retinal vein occlusion with bevacizumab. Curr Opin Ophthalmol 19:234–238

    Article  PubMed  Google Scholar 

  7. Costa RA, Jorge R, Calucci D, Melo LA Jr, Cardillo JA, Scott IU (2007) Intravitreal bevacizumab (avastin) for central and hemicentral retinal vein occlusions: IBeVO study. Retina 27:141–149

    Article  PubMed  Google Scholar 

  8. Hoh AE, Schaal KB, Scheuerle A, Schutt F, Dithmar S (2008) OCT-guided reinjection of 2.5 mg bevacizumab for treating macular edema due to retinal vein occlusion. Ophthalmologe 105:1121–1126

    Article  CAS  PubMed  Google Scholar 

  9. Jaissle GB, Ziemssen F, Petermeier K, Szurman P, Ladewig M, Gelisken F, Volker M, Holz FG, Bartz-Schmidt KU (2006) [Bevacizumab for treatment of macular edema secondary to retinal vein occlusion.]. Ophthalmologe 103:471–475

    Article  CAS  PubMed  Google Scholar 

  10. Priglinger SG, Wolf AH, Kreutzer TC, Kook D, Hofer A, Strauss RW, Alge CS, Kunze C, Haritoglou C, Kampik A (2007) Intravitreal bevacizumab injections for treatment of central retinal vein occlusion: six-month results of a prospective trial. Retina 27:1004–1012

    Article  PubMed  Google Scholar 

  11. Rabena MD, Pieramici DJ, Castellarin AA, Nasir MA, Avery RL (2007) Intravitreal bevacizumab (Avastin) in the treatment of macular edema secondary to branch retinal vein occlusion. Retina 27:419–425

    Article  PubMed  Google Scholar 

  12. Schaal KB, Hoh AE, Scheuerle A, Schutt F, Dithmar S (2007) Bevacizumab for the treatment of macular edema secondary to retinal vein occlusion. Ophthalmologe 104:285–289

    Article  CAS  PubMed  Google Scholar 

  13. Iturralde D, Spaide RF, Meyerle CB, Klancnik JM, Yannuzzi LA, Fisher YL, Sorenson J, Slakter JS, Freund KB, Cooney M, Fine HF (2006) Intravitreal bevacizumab (Avastin) treatment of macular edema in central retinal vein occlusion: a short-term study. Retina 26:279–284

    Article  PubMed  Google Scholar 

  14. The Central Vein Occlusion Study Group (1997) Natural history and clinical management of central retinal vein occlusion. Arch Ophthalmol 115:486–491

    Google Scholar 

  15. Chen JC, Klein ML, Watzke RC, Handelman IL, Robertson JE (1995) Natural course of perfused central retinal vein occlusion. Can J Ophthalmol 30:21–24

    CAS  PubMed  Google Scholar 

  16. Zhang H, Xia Y (2002) Analysis of visual prognosis and correlative factors in retinal vein occlusion. Zhonghua Yan Ke Za Zhi 38:98–102

    PubMed  Google Scholar 

  17. Esrick E, Subramanian ML, Heier JS, Devaiah AK, Topping TM, Frederick AR, Morley MG (2005) Multiple laser treatments for macular edema attributable to branch retinal vein occlusion. Am J Ophthalmol 139:653–657

    Article  PubMed  Google Scholar 

  18. Subramanian ML, Heier JS, Esrick E, Devaiah AK, Topping TM, Frederick AR, Morley MG (2006) Preoperative visual acuity as a prognostic indicator for laser treatment of macular edema due to branch retinal vein occlusion. Ophthalmic Surg Lasers Imaging 37:462–467

    PubMed  Google Scholar 

  19. Sasahara M, Mikawa A, Tajiri K, Kojima H, Saito I (2006) Visual prognosis of branch retinal vein occlusion with macular edema. Nippon Ganka Gakkai Zasshi 110:293–299

    PubMed  Google Scholar 

  20. Glacet-Bernard A, Coscas G, Chabanel A, Zourdani A, Lelong F, Samama MM (1996) Prognostic factors for retinal vein occlusion: prospective study of 175 cases. Ophthalmology 103:551–560

    CAS  PubMed  Google Scholar 

  21. Klein R, Moss SE, Meuer SM, Klein BE (2008) The 15-year cumulative incidence of retinal vein occlusion: the Beaver Dam Eye Study. Arch Ophthalmol 126:513–518

    Article  PubMed  Google Scholar 

  22. Noma H, Funatsu H, Yamasaki M, Tsukamoto H, Mimura T, Sone T, Jian K, Sakamoto I, Nakano K, Yamashita H, Minamoto A, Mishima HK (2005) Pathogenesis of macular edema with branch retinal vein occlusion and intraocular levels of vascular endothelial growth factor and interleukin-6. Am J Ophthalmol 140:256–261

    CAS  PubMed  Google Scholar 

  23. Noma H, Funatsu H, Mimura T, Hori S (2008) Changes of vascular endothelial growth factor after vitrectomy for macular edema secondary to retinal vein occlusion. Eur J Ophthalmol 18:1017–1019

    CAS  PubMed  Google Scholar 

  24. Pe’er J, Folberg R, Itin A, Gnessin H, Hemo I, Keshet E (1998) Vascular endothelial growth factor upregulation in human central retinal vein occlusion. Ophthalmology 105:412–416

    Article  PubMed  Google Scholar 

  25. Matsumoto Y, Freund KB, Peiretti E, Cooney MJ, Ferrara DC, Yannuzzi LA (2007) Rebound macular edema following bevacizumab (Avastin) therapy for retinal venous occlusive disease. Retina 27:426–431

    Article  PubMed  Google Scholar 

  26. Rath EZ, Frank RN, Shin DH, Kim C (1992) Risk factors for retinal vein occlusions. A case-control study. Ophthalmology 99:509–514

    CAS  PubMed  Google Scholar 

  27. Chung EJ, Hong YT, Lee SC, Kwon OW, Koh HJ (2008) Prognostic factors for visual outcome after intravitreal bevacizumab for macular edema due to branch retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 246:1241–1247

    Article  CAS  PubMed  Google Scholar 

  28. Lang GE, Handel A (1992) Clinical and fluorescein angiography changes in patients with central retinal vein occlusion. A unicenter study of 125 patients. Klin Monatsbl Augenheilkd 201:302–308

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany

    Thomas Ach, Alexandra E. Hoeh, Karen B. Schaal, Alexander F. Scheuerle & Stefan Dithmar

Authors
  1. Thomas Ach
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  2. Alexandra E. Hoeh
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  3. Karen B. Schaal
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  4. Alexander F. Scheuerle
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  5. Stefan Dithmar
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Corresponding author

Correspondence to Stefan Dithmar.

Additional information

This work was presented in part at the 106th meeting of the Deutsche Ophthalmologische Gesellschaft (DOG)

Financial relationship: No author has any financial interest in the manuscript.

Supported by the Gertrud Kusen Foundation (Di2008)

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Ach, T., Hoeh, A.E., Schaal, K.B. et al. Predictive factors for changes in macular edema in intravitreal bevacizumab therapy of retinal vein occlusion. Graefes Arch Clin Exp Ophthalmol 248, 155–159 (2010). https://doi.org/10.1007/s00417-009-1167-6

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  • DOI: https://doi.org/10.1007/s00417-009-1167-6

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