Purpose: To evaluate the results of intravitreal bevacizumab (IVB) injection on contrast sensitivity (CS), best-corrected visual acuity (BCVA), foveal thickness (FT) and macular volume (MV) as measured by optical coherence tomography in patients with macular edema (ME) from central retinal vein occlusion (CRVO). Methods: Sixteen consecutive eyes from 16 patients with ME from unilateral CRVO were treated with a single IVB injection. The CS, BCVA, FT and MV measurements were obtained before the treatment and 1 and 3 months after the injection. Results: CS demonstrated significant improvement at all spatial frequencies - 1.5, 3, 6, 12 and 18 cycles per degree (cpd) - 1 month after the injection and at 6 cpd at the 3-month follow-up. The mean BCVA measurements in log of the minimum angle of resolution (logMAR) units improved from 1.03 at baseline to 0.83 logMAR 1 month after the injection, but worsened to 0.97 logMAR at 3 months. The mean baseline FT ± standard deviation (SD; 620.06 ± 177.60 µm) was reduced significantly 1 month (270.93 ± 74.17 µm) and 3 months (535.56 ± 222.33 µm) after the treatment. The mean baseline MV ± SD (12,765.56 ± 3,769.70 mm3) was reduced significantly at the 1-month (8,324.93 ± 932.04 mm3) and 3-month (11,319.44 ± 3,044.74 mm3) follow-up visits. Conclusions: IVB improved CS, BCVA, FT and MV within a short time period (1 month). Although VA was not improved at 3 months, improvements were observed for CS, FT and MV, which indicates that, despite ME recurrence, there still was some benefit to visual function.

Keywords:
Angiogenesis inhibitors, Bevacizumab, Central retinal vein occlusion, Intravitreal injection, Macular edema, Optical coherence tomography, Retinal vein occlusion, Vascular endothelial growth factor
1.
Central vein occlusion study of photocoagulation therapy. Baseline findings. Central Vein Occlusion Study Group. Online J Curr Clin Trials 1993;doc No 95.
2.
Natural history and clinical management of central retinal vein occlusion. The Central Vein Occlusion Study Group. Arch Ophthalmol 1997;115:486-491.
3.
Hayreh SS: Classification of central retinal vein occlusion. Ophthalmology 1983;90:458-474.
4.
Aiello LP, Avery RL, Arrigg PG, Keyt BA, Jampel HD, Shah ST, et al: Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med 1994;331:1480-1487.
5.
Frank RN, Amin RH, Eliott D, Puklin JE, Abrams GW: Basic fibroblast growth factor and vascular endothelial growth factor are present in epiretinal and choroidal neovascular membranes. Am J Ophthalmol 1996;122:393-403.
6.
Keck PJ, Hauser SD, Krivi G, Sanzo K, Warren T, Feder J, et al: Vascular permeability factor, an endothelial cell mitogen related to PDGF. Science 1989;246:1309-1312.
7.
Senger DR, Connolly DT, van de Water L, Feder J, Dvorak HF: Purification and NH2-terminal amino acid sequence of guinea pig tumor-secreted vascular permeability factor. Cancer Res 1990;50:1774-1778.
8.
Murdoch IE, Rosen PH, Shilling JS: Neovascular response in ischaemic central retinal vein occlusion after panretinal photocoagulation. Br J Ophthalmol 1991;75:459-461.
9.
Yang JC, Haworth L, Sherry RM, Hwu P, Schwartzentruber DJ, Topalian SL, et al: A randomized trial of bevacizumab, an anti-vascular endothelial growth factor antibody, for metastatic renal cancer. N Engl J Med 2003;349:427-434.
10.
Iturralde D, Spaide RF, Meyerle CB, Klancnik JM, Yannuzzi LA, Fisher YL, et al: Intravitreal bevacizumab (Avastin) treatment of macular edema in central retinal vein occlusion: a short-term study. Retina 2006;26:279-284.
11.
Jaissle GB, Ziemssen F, Petermeier K, Szurman P, Ladewig M, Gelisken F, et al: Bevacizumab for treatment of macular edema secondary to retinal vein occlusion (in German). Ophthalmologe 2006;103:471-475.
12.
Kahook MY, Schuman JS, Noecker RJ: Intravitreal bevacizumab in a patient with neovascular glaucoma. Ophthalmic Surg Lasers Imaging 2006;37:144-146.
13.
Priglinger SG, Wolf AH, Kreutzer TC, Kook D, Hofer A, Strauss RW, et al: Intravitreal bevacizumab injections for treatment of central retinal vein occlusion: six-month results of a prospective trial. Retina 2007;27:1004-1012.
14.
Hsu J, Kaiser RS, Sivalingam A, Abraham P, Fineman MS, Samuel MA, et al: Intravitreal bevacizumab (Avastin) in central retinal vein occlusion. Retina 2007;27:1013-1019.
15.
Jin CJ, Wu DZ, Wu L: The contrast sensitivity function in low vision. Yan Ke Xue Bao 1992;8:45-48.
16.
Arden GB: The importance of measuring contrast sensitivity in cases of visual disturbance. Br J Ophthalmol 1978;62:198-209.
17.
Campbell FW, Maffei L: Contrast and spatial frequency. Sci Am 1974;231:106-114.
18.
Rubin G: Reliability and sensitivity of clinical contrast sensitivity tests. Clin Vis Sci 1988;2:169-177.
19.
Rubin GS, Bandeen-Roche K, Huang GH, Munoz B, Schein OD, Fried LP, et al: The association of multiple visual impairments with self-reported visual disability: SEE project. Invest Ophthalmol Vis Sci 2001;42:64-72.
20.
Mones J, Rubin GS: Contrast sensitivity as an outcome measure in patients with subfoveal choroidal neovascularisation due to age-related macular degeneration. Eye (Lond) 2005;19:1142-1150.
21.
Preti RC, Ramirez LM, Pimentel SL, Motta AA, Machado CG, Monteiro ML, et al: Single intravitreal bevacizumab injection effects on contrast sensitivity in macular edema from branch retinal vein occlusion. Arq Bras Oftalmol 2012;75:29-32.
22.
Algvere PV, von Wendt G, Gudmundsson J, Seregard S, Kvanta A: Visual improvement in central retinal vein occlusion (CRVO) following intravitreal injections of bevacizumab (Avastin®). Acta Ophthalmol 2010;88:836-841.
23.
Aiello LP, Brucker AJ, Chang S, Cunningham ET Jr, D'Amico DJ, Flynn HW Jr, et al: Evolving guidelines for intravitreous injections. Retina 2004;24(5 suppl):S3-S19.
24.
A randomized clinical trial of early panretinal photocoagulation for ischemic central vein occlusion. The Central Vein Occlusion Study Group N report. Ophthalmology 1995;102:1434-1444.
25.
Evaluation of grid pattern photocoagulation for macular edema in central vein occlusion. The Central Vein Occlusion Study Group M report. Ophthalmology 1995;102:1425-1433.
26.
della Sala S, Bertoni G, Somazzi L, Stubbe F, Wilkins AJ: Impaired contrast sensitivity in diabetic patients with and without retinopathy: a new technique for rapid assessment. Br J Ophthalmol 1985;69:136-142.
27.
Ota M, Tsujikawa A, Kita M, Miyamoto K, Sakamoto A, Yamaike N, et al: Integrity of foveal photoreceptor layer in central retinal vein occlusion. Retina 2008;28:1502-1508.
28.
Martinet V, Guigui B, Glacet-Bernard A, Zourdani A, Coscas G, Soubrane G, et al: Macular edema in central retinal vein occlusion: correlation between optical coherence tomography, angiography and visual acuity. Int Ophthalmol 2012;32:369-377.
29.
Brown DM, Campochiaro PA, Singh RP, Li Z, Gray S, Saroj N, et al: Ranibizumab for macular edema following central retinal vein occlusion: six-month primary end point results of a phase III study. Ophthalmology 2010;117:1124-1133e1.
© 2014 S. Karger AG, Basel
2014
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.