Intravitreal bevacizumab in central retinal vein occlusion: 18-month results of a prospective clinical trial

PURPOSE. To evaluate the long-term visual results in central retinal vein occlusion (CRVO) following repeated intravitreal injections of bevacizumab (IVB). METHODS. Thirteen patients (aged 34 to 79 years) with a duration of CRVO of 2 weeks to 6 months (mean 2.5 months) had a best-corrected visual acuity (BCVA) 0.05 to 0.4 (mean 0.13) as determined by Early Treatment Diabetic Retinopathy Study (ETDRS) chart. Clinical examination was carried out at baseline and every 6 to 8 weeks. Intravitreal bevacizumab (1.25 mg) was given every 6 weeks during the first 6 months, and after that at the discretion of the attending physician. RESULTS. In total, 96 IVB (average 7.4/patient) were given: 50 IVB during the first 6 months, 28 from 6 to 12 months, and 18 from 12 to 18 months. Average BCVA had improved 15 ETDRS letters at 3 months, 24 letters at 6 months, 24 letters at 12 months, and 18 letters at 18 months (p<0.05). Eight patients (62%) had gained >15 ETDRS letters at 12 months, and 7 subjects (54%) >15 ETDRS letters at 18 months. Foveal thickness decreased from 596 mu m at baseline to 294 mu m at 18 months (p<0.05) and mean IOP from 15.2 mmHg to 15.8 mmHg. No serious adverse events occurred. CONCLUSIONS. Following repeated IVB, there was a significant gain of BCVA during the follow-up of 18 months. To maintain visual gain, regular ophthalmologic examinations and repeated injections seem to be necessary as long as the disease is active.