Intravitreal Bevacizumab treatment for branch retinal vein occlusion accompanied by macular edema

Abstract

Objective To compare the efficacy of intravitreal bevacizumab (IVB) in the treatment of macular edema, with or without foveal hemorrhage within the foveal cystoid apaces, subretinal hemorrhage (SRH) and serous retinal detachment (SRD) resulting from branch retinal vein occlusion (BRVO). Methods A retrospective review of 33 consecutive patients (33 eyes) was conducted with ME caused by acute BRVO. All patients received a comprehensive ophthalmologic examination, including measurement of best-corrected visual acuity (BCVA), measurement of intraocular pressure, slit-lamp biomicroscopy, color fundus photograghy, fluorescein angiography, and spectral domain optical coherence tomography (SD-OCT). Using hemorrhage within the foveal cystoid apaces, subretinal hemorrhage (SRH) and serous retinal detachment (SRD) three factors, the multiple logistic model were developed. Results Foveal SRH was closely correlated with BCVA. Patients were classified into one of two groups depending on whether or not foveal SRH was detected at the initial visit, BCVA and central macular thickness (CMT) were observed. After 6 months, SD-OCT revealed serous reti-nal detachments in the fovea of 15 eyes, 10 of which had accompanying foveal SRH. Based on initial detection of foveal SRH, patients were divided into SRH-negative (23 eyes) or SRH-positive (10 eyes) groups. Initial BCVA did not differ between the two groups. In the SRH-negative group, both BCVA and CMT improved significantly after IVB injections (mean, 2.3 injections) at the 6-months follow-up examination. In the SRH-positive group, there was no significant improvement in BCVA after IVB injections (mean, 2.0 injections), although there was a significant decrease in CMT. The final BCVA of the SRH-positive group was significantly poorer than that of the SRH-negative group (P=0.001). Conclusions The presence of foveal SRH may be a negative predictor of IVB treatment outcomes for BRVO patients with ME. Key words: Branch retinal vein occlusion; Hemorrhage within the foveal cystoid apaces; Serous retinal detachment; Subretinal hemorrhage; Macular edema; Bevacizumab