The Effects of Intravitreal Bevacizumab in Infectious and Noninfectious Uveitic Macular Edema

Background/Aims.To assess the effect of intravitreal bevacizumab injection (IVBI) for the treatment of macular edema due to infectious and noninfectious uveitides.Design.Retrospective interventional case series.Methods.A chart review was performed on all the patients who were diagnosed with uveitic macular edema (UME) and received 1.25 mg of IVBI at two referral centers in Riyadh, Saudi Arabia. All included patients had their visual acuity and macular thickness analyzed at baseline and at 1 and 3 months following IVBI and any sign of reactivation was noted.Results.The mean age of patients was41±16years with a mean followup of4±1months. Ten patients had idiopathic intermediate uveitis, 9 patients had Behcet’s disease, 10 had idiopathic panuveitis, and twelve patients had presumed ocular tuberculosis uveitis. Following IVBI, the mean LogMAR visual acuity improved from0.8±0.8at baseline to0.4±0.5at 1 month and0.3±0.5at 3 months (P<0.002, at 3 months). The mean macular thickness was430±132 μm at baseline. Following IVBI macular thickness improved to286±93 μm at 1 month and to265±88 μm at 3 months of followup (P<0.001, at 3 months).Conclusion.Bevacizumab was effective in the management of UME associated with both infectious and noninfectious uveitides. Intravitreal bevacizumab induced remission of UME with infectious uveitis and had no immunosuppressive effect against infectious agents.

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Intravitreal Bevacizumab in Refractory Uveitic Macular Edema: One-year Follow-up

European Journal of Ophthalmology ◽

10.1177/112067210901900417 ◽

2009 ◽

Vol 19 (4) ◽

pp. 622-629 ◽

Cited By ~ 34

Author(s):

Rene A. Cervantes-Castañeda ◽

Gian Paolo Giuliari ◽

Michael J. Gallagher ◽

Taygan Yilmaz ◽

Rebecca E. Macdonell ◽

...

Keyword(s):

Visual Acuity ◽

Combination Therapy ◽

Macular Edema ◽

Triamcinolone Acetonide ◽

Intravitreal Bevacizumab ◽

Central Macular Thickness ◽

Intravitreal Bevacizumab Injection ◽

Uveitic Macular Edema ◽

The Mean ◽

Bevacizumab Injection

Purpose Uveitis is a major cause of ocular morbidity in developed countries. It has been demonstrated that macular edema is a significant cause of decreased visual acuity and macular edema in these patients. In this article, we evaluate the long-term outcome of intravitreal bevacizumab in the treatment of refractory uveitic macular edema. Methods In this retrospective, noncomparative, interventional case series, uveitic patients with macular edema who were refractory to conventional therapy and who were treated with intravitreal bevacizumab were identified and assessed. Best-corrected visual acuity and optical coherence tomography central macular thickness measurements were collected and analyzed with correlative statistical analysis, including the use of Student paired t-test, Kaplan-Meier, and linear regression analysis. Results Twenty-nine eyes of 27 patients with diverse uveitic etiologies were analyzed and followed up at 1 year. Thirteen patients received a single intravitreal bevacizumab injection. Six patients required a second intravitreal bevacizumab injection, while 10 patients received combination therapy of intravitreal bevacizumab and triamcinolone acetonide. Baseline mean logMAR visual acuity was −0.59. At 1 year, the mean logMAR visual acuity was −0.42± 0.36 (p=0.0045). Baseline mean central macular thickness was 383.66 μm. At 1 year, the mean thickness was 294.32±110.87 (p=0.0007). Conclusions Intravitreal bevacizumab is a useful and therapeutically beneficial agent in the treatment of refractory uveitic macular edema. Some patients will require adjunctive intravitreal bevacizumab injections or the use of combination therapy with intravitreal triamcinolone acetonide.

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Combined Intravitreal Bevacizumab and Laser Photocoagulation to Treat Retinal Arterial Macroaneurysms

Journal of the Korean Ophthalmological Society ◽

10.3341/jkos.2021.62.8.1053 ◽

2021 ◽

Vol 62 (8) ◽

pp. 1053-1060

Author(s):

Tae Hoon Kim ◽

Chang Zoo Kim ◽

Seung Uk Lee ◽

Sang Joon Lee

Keyword(s):

Visual Acuity ◽

Laser Photocoagulation ◽

Lipid Level ◽

Intravitreal Bevacizumab ◽

Macular Thickness ◽

Intravitreal Bevacizumab Injection ◽

Photocoagulation Treatment ◽

The Mean ◽

Bevacizumab Injection

Purpose: To investigate the effects of intravitreal bevacizumab injection combined with laser photocoagulation in patients with retinal microaneurysms.Methods: We retrospectively reviewed the medical records of 21 eyes of 21 patients who underwent intravitreal bevacizumab injection and/or laser photocoagulation to treat retinal macroaneurysms. Eleven eyes received the combination therapy (CT) and 10 eyes monotherapy (MT) (either bevacizumab injection or laser photocoagulation). Changes in visual acuity, central macular thickness, macroaneurysm size and location, blood pressure, and the lipid level were compared between the two groups.Results: The mean patient age was 74.0 ± 10.5 years and the mean study period 7.0 ± 5.3 months. The mean macroaneurysm diameter of the CT group was 480.00 ± 292.30 μm and that of the MT group 328.75 ± 87.09 μm. The diameter was significantly larger in the CT group (p = 0.002). The initial visual acuities were 0.91 ± 0.66 and 0.88 ± 0.83 in the CT and MT groups, respectively. At the 4-month follow-up, the visual acuities were 0.33 ± 0.26 and 0.17 ± 0.29 in the CT and MT groups, respectively, and had significantly improved only in the CT group (p = 0.042). The initial central macular thicknesses were 441.82 ± 226.81 and 541.63 ± 401.97 μm in the CT and MT groups, respectively. At the 4-month follow-up, the figures were 293.60 ± 46.10 and 269.00 ± 48.34 μm in the CT and MT groups, respectively, and had significantly decreased only in the CT group (p = 0.043). Compared to the initial findings, the proportion of patients whose final visual acuities improved by more than two lines were 73% and 40%, respectively, thus significantly higher in the CT group (p < 0.001).Conclusions: Combined intravitreal bevacizumab injection and laser photocoagulation treatment of retinal macroaneurysms improve visual acuity and decrease macular thickness.

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Intravitreal bevacizumab injection alone or combined with macular photocoagulation compared to macular photocoagulation as primary treatment of diabetic macular edema

Vojnosanitetski pregled ◽

10.2298/vsp140402074j ◽

2015 ◽

Vol 72 (10) ◽

pp. 876-882 ◽

Cited By ~ 5

Author(s):

Sandra Jovanovic ◽

Vladimir Canadanovic ◽

Ana Sabo ◽

Zorka Grgic ◽

Milena Mitrovic ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Laser Treatment ◽

Diabetic Macular Edema ◽

Combined Treatment ◽

Intravitreal Bevacizumab ◽

Primary Treatment ◽

Intravitreal Bevacizumab Injection ◽

Vegf Inhibitor ◽

The Mean

Background/Aim. Within diabetic retinopathy (DR), diabetic macular edema (DME) is one of the leading causes of the loss of visual acuity. The aim of this study was to determine the efficacy of the intravitreal vascular endothelial growth factor (VEGF) inhibitor application alone or combined with macular focal/grid lasephotocoagulation compared with laser treatment alone. Methods. This prospective randomized clinical trial included 72 patients (120 treated eyes) with varying degrees of DR and DME. The DME treatment included intravitreal VEGF inhibitor bevacizumab (Avastin?) application, with and without laser treatment. Bevacizumab (1.25 mg/0.05 mL) was administered intravitreally in 4-6-week intervals. Laser is applied 4-6 weeks after last dose of the drug as a part of combined treatment, or as the primary treatment. Results. The mean reduction in central macular thickness (CMT) for the eyes (n = 31) treated with bevacizumab alone was 162.23 ?m, for the eyes (n = 53) treated with combined treatment the mean reduction in CMT was 124.24 ?m, both statistically significant at p < 0.001. Laser macular photocolagulation as a part of combined treatment (in 53 eyes) significantly contributed to the CMT reduction, based on the paired t-test results (366.28 vs 323.0 ?m at p < 0.05). In our study, the mean visual acuity improvement of 0.161 logMAR was achieved in the group of eyes treated with bevacizumab alone, and 0.093 logMAR in the group with combined treatment, both statistically significant at p < 0.05. The effect of laser photocolagulation alone on visual acuity and CMT was not statistically significant. Conclusion. Treatment with bevacizumab alone or within combined treatment is more effective in treating DME than conventional macular laser treatment alone, both anatomically and functionally.

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Outcomes of Intravitreal Bevacizumab in Patients with Diabetic Macular Edema at a Tertiary Hospital in Northern Tanzania

Ophthalmology Research An International Journal ◽

10.9734/or/2020/v12i430153 ◽

2020 ◽

pp. 27-34

Author(s):

Shariza Kanji ◽

Kazim Dhalla ◽

William Makupa

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Intravitreal Bevacizumab ◽

Macular Thickness ◽

Central Macular Thickness ◽

Central Vision ◽

Macular Volume ◽

The Mean ◽

Anatomical Outcomes

Background: Diabetic macular edema is a type of diabetic maculopathy affecting the central vision, ranging from mild blur to blindness. Laser photocoagulation has been the mainstay of treatment for the past three decades but it has a limited role in improving the central vision. Recent introduction of anti-vascular endothelial growth factors appears to be promising in restoring vision. However, due to its short half life multiple injections are required to control edema and maintain vision. Objectives: To determine the visual and anatomical outcomes of intravitreal bevacizumab in patients with diabetic macular edema. Methods: A hospital based retrospective cross-sectional study was done at Kilimanjaro Christian Medical Center eye department from 2011- 2015. During this time, patients with diabetic macular edema who were given intravitreal bevacizumab and satisfied the inclusion criteria were included in the study. Visual acuity, central macular thickness and macular volume were recorded at baseline, six, twelve, eighteen, twenty four and thirty weeks respectively. Optical coherence tomography was used to record central macular thickness and macular volume. Univariate and multivariate binary regression analysis were done and the p-value, odds ratio and 95% confidence interval were calculated. Results: The prevalence of Diabetic macular edema was 15.4%. Mean baseline visual acuity improved from 0.9 ± 0.57 log MAR (6/48) to 0.6±0.49 log MAR (6/24) (95% CI 0.207 - 0.389) at 30 weeks. The mean baseline central macular thickness decreased from 426.97 ± 148.358 μm to 280.98 ± 95.89 μm at 30 weeks (95% 151.531 - 187.044, P < .001). The mean baseline macular volume decreased significantly from 10.59 ± 2.55 mm3 to 8.38 ± 1.498 mm3 (95% CI 1.860 - 2.886) at 30 weeks. In multivariate analysis, patients with no hypertension were more likely to have a better visual outcome of 6/18 or better (95% CI 1.064 - 4.420, P < .033). Conclusion: This study shows a high burden of diabetic macular edema in our setting. Intravitreal bevacizumab injection results in better visual and anatomical outcomes.

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Functional and structural outcome after vitrectomy combined with subretinal rtPA Injection with or without additional intravitreal Bevacizumab injection for submacular hemorrhages

PLoS ONE ◽

10.1371/journal.pone.0250587 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0250587

Author(s):

Annekatrin Rickmann ◽

Lina R. Paez ◽

Maria della Volpe Waizel ◽

Lukas Bisorca-Gassendorf ◽

André Schulz ◽

...

Keyword(s):

Visual Acuity ◽

Case Series ◽

Intravitreal Bevacizumab ◽

Age Related Macular Degeneration ◽

Subretinal Space ◽

Intravitreal Bevacizumab Injection ◽

Age Related ◽

The Mean ◽

Group B ◽

Bevacizumab Injection

Background To analyze the functional and anatomical outcome after vitrectomy with subretinal rtPA (recombinant tissue plasminogen activator) combined with or without an intravitreal Bevacizumab injection. Patients and methods Retrospective, consecutive case series of 31 pseudophakic patients with submacular hemorrhage (SMH) due to neovascular age-related macular degeneration (AMD) treated with vitrectomy, subretinal rtPA and pneumatic air displacement with or without an additional intravitreal Bevacizumab injection. The primary endpoints were best-corrected visual acuity (BCVA), and central macular thickness (CMT) measured by SD‑OCT. The secondary endpoint was a displacement of hemorrhage from the subretinal space three months after surgery. Results 31 eyes of 31 patients were treated with vitrectomy and subretinal rtPA. 17/31 were treated simultaneously with an intravitreal Bevacizumab injection (group +B) and 14/31 without (group -B). The mean visual acuity improved significantly in both groups (from 1.37±0.39 to 1.03±0.57 logMAR in +B and from 1.48±0.48 to 1.01±0.38 logMAR in group –B, p<0.05). The mean CMT decreased in group +B from 607±179 μm to 424±205 μm (p = 0.2) and in group –B from 722±216 μm to 460±202 μm (p<0.05). A central displacement of the hemorrhage could be achieved in 47% in group +B, whereas in group -B displacement could be achieved in 50% (p = 0.44). Conclusions Vitrectomy with subretinal rtPA injection and air tamponade with or without simultaneous intravitreal Bevacizumab injection displaces SMH and improves BCVA effectively. In comparison, the postoperative outcome is comparable regardless of whether or not intravitreal bevacizumab is applied simultaneously.

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Evaluation of Intravitreal Bevacizumab injection in treatment of diabetic macular edema in eyes with Good visual acuity

10.21203/rs.3.rs-36672/v1 ◽

2021 ◽

Author(s):

seyed aliasghar mosavi

Keyword(s):

Visual Acuity ◽

Treatment Group ◽

Macular Edema ◽

Intravitreal Bevacizumab ◽

Macular Thickness ◽

Control Group ◽

The Mean ◽

The Difference ◽

Good Vision

Abstract Aims To determine the effect of intravitreous Bevacizumab injection on reducing diabetic macular edema in patients with good vision. Method : This clinical trial was conducted on diabetic patients with centrally involved macular edema and good vision over a period of one and a half year. 22 eyes of 12 patients with a visual acuity of Snellen equivalent of 20/25 or better in the non-proliferative stage with the central macular thickness of more than 300 microns in optical coherence tomography (OCT) were evaluated. In the injection group 1.25 Mg of bevacizumab (Avastin) was injected intravitreally and the control group was followed up. Macular thickness and visual acuity were measured in two groups at first and sixth months after injection. Results Intravitreal bevacizumab was injected in 12 eyes (55%) and 10 patients were followed-up as a control group (45%). The mean central macular thickness was 319 µm at first visit and 301 µm at month six in the treatment group and in the control group it was 318 µm and 328 µm respectively. The mean macular thickness of the treatment group was significantly decreased (p = 0.031), but the difference was not statistically significant between two groups (p = 0.581). The mean visual acuity in the treatment group was 0.045 Log MAR at first visit and 0.033 Log MAR at the sixth month follow up, these values in the control group were 0.1 Log MAR and 0.045 Log MAR respectively and did not differ statistically between the two groups (p = 0.373) Conclusion Although the mean macular thickness was reduced in the treatment group with visual acuity of 20/25 or better but the difference was not significant during follow-up at least in a short period. Therefore, the role of underlying factors other than VEGF alone can be notable in the pathogenesis of the disease.

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Change in Visual Acuity in Relation to Central Macular Thickness after Intravitreal Bevacizumab in Diabetic Macular Edema

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v36i3.1051 ◽

2020 ◽

Vol 36 (3) ◽

Author(s):

Muhammad Ali Haider ◽

Uzma Sattar ◽

Syeda Rushda Zaidi

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Intravitreal Bevacizumab ◽

Macular Thickness ◽

Rank Test ◽

P Value ◽

Central Macular Thickness ◽

Anti Vegf ◽

Quasi Experimental

Purpose: To evaluate the change in visual acuity in relation to decrease in central macular thickness,after a single dose of intravitreal Bevacizumab injection.Study Design: Quasi experimental study.Place and Duration of Study: Punjab Rangers Teaching Hospital, Lahore, from January 2019 to June 2019.Material and Methods: 70 eyes with diabetic macular edema were included in the study. Patients having high refractive errors (spherical equivalent of > ± 7.5D) and visual acuity worse than +1.2 or better than +0.2 on log MAR were excluded. Central macular edema was measured in μm on OCT and visual acuity was documentedusing Log MAR chart. These values were documented before and at 01 month after injection with intravitrealBevacizumab. Wilcoxon Signed rank test was used to evaluate the difference in VA beforeand after the anti-VEGF injection. Difference in visual acuity and macular edema (central) was observed,analyzed and represented in p value. P value was considered statistically significant if it was less than 0.01%.Results: Mean age of patients was 52.61 ± 1.3. Vision improved from 0.90 ± 0.02 to 0.84 ± 0.02 on log MARchart. The change was statistically significant with p value < 0.001. Central macular thickness reduced from 328 ±14 to 283 ± 10.6 μm on OCT after intravitreal anti-VEGF, with significant p value < 0.001.Conclusion: A 45 μm reduction in central macular thickness was associated with 0.1 Log MAR unit improvementin visual acuity after intravitreal Bevacizumab in diabetic macular edema.

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The Difference Of Visual Acuity And Macular Thickness Post Bevacizumab Therapy In Secondary Macular Edema Retinal Vein Occlusion

Journal of Agromedicine and Medical Sciences ◽

10.19184/ams.v4i2.7875 ◽

2018 ◽

Vol 4 (2) ◽

pp. 110

Author(s):

Citra Rahmadani ◽

Nur Khoma Fatmawati ◽

Rahmat Bakhtiar

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Retinal Vein Occlusion ◽

Secondary Data ◽

Macular Thickness ◽

Vein Occlusion ◽

Before And After ◽

Quasi Experimental ◽

The Mean ◽

The Difference

Retinal vein occlusion is the second most common cause of blindness in retinal vascular disease after diabetic retinopathy and may lead to complications of macular edema. Bevacizumab is an influential treatment as an anti vascular endothelial growth factor (VEGF). This study aims to determine the difference of visual acuity and macular thickness before and after treatment of Bevacizumab. This is a quasi experimental study in patients with secondary macular edema retinal vein occlusion who meets the inclusion criteria. Visual acuity and macular thickness were evaluated after one month of treatment. This study was conducted for two months since May-June 2017 by collecting secondary data from medical record at SMEC Samarinda from January 2016 – June 2017. Data were analyzed using Wilcoxon. Sixteen eyes from 16 patients were diagnosed with macular edema secondary retinal vein occlusion given bevacizumab treatment. The mean visual acuity before therapy was 1.106 LogMAR ± 0.509 and increased to 0.889 logMAR ± 0.608 (p = 0.116) after treatment while the mean macular thickness before therapy was 504.06 μm ± 301.273 and decreased to 348.81 μm ± 181.17 (p = 0.017) after treatment. There was a significant effect on the decrease in macular thickness but no significant effect on visual acuity improvement in patients with macular edema secondary retinal vein occlusion at SMEC Samarinda. Keywords: Retinal vein occlusion, macular edema, bevacizumab

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Effect of Intravitreal Bevacizumab Injection before Panretinal Photocoagulation on the Prevention of Macular Edema Aggravation in Proliferative Diabetic Retinopathy

Journal of Clinical Medicine ◽

10.3390/jcm9113772 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3772

Author(s):

Wungrak Choi ◽

Hyun Goo Kang ◽

Eun Young Choi ◽

Sung Soo Kim ◽

Hyoung Jun Koh ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Outcome Measure ◽

Intravitreal Bevacizumab ◽

Primary Outcome Measure ◽

Secondary Outcome ◽

Combination Group ◽

Panretinal Photocoagulation ◽

Secondary Outcome Measure ◽

Intravitreal Bevacizumab Injection

Objective: To investigate the effects of intravitreal bevacizumab (IVB) injection before PRP on the prevention of macular edema (ME) in patients with PDR. Methods: This retrospective observational study included patients diagnosed with PDR treated by PRP with (combination group) or without (PRP alone group) preoperative IVB injection (1.25 mg/0.05 mL). The primary outcome measure was the change in the central macular thickness (CMT), while the secondary outcome measure was the change in visual acuity. Measurements were made before and at one, two, and three months after treatment. Results: In the PRP alone group, the mean baseline CMT of 277.8 μm increased to 290.4 μm at one month (p = 0.201) and 308.8 μm at two months (p = 0.002), followed by a decrease to 271.2 μm at three months (p = 0.437). In the combination group, the values at baseline and one, two, and three months after PRP were 322.9 μm, 295.4 μm (p = 0.002), 330.1 μm (p = 0.906), and 274.5 μm (p = 0.030), respectively. Visual acuity changes were comparable between the two groups at all time points. Conclusion: IVB injection before PRP leads to decreased CMT in comparison to CMT in patients with PRP alone.

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Real-Life Management of Patients with Retinal Vein Occlusion Using I-Macula Web Platform

Journal of Ophthalmology ◽

10.1155/2017/5601786 ◽

2017 ◽

Vol 2017 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Massimo Nicolò ◽

Monica Bonetto ◽

Raffaella Rosa ◽

Donatella Musetti ◽

Maria Musolino ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Retinal Vein Occlusion ◽

Real Life ◽

Macular Thickness ◽

Central Macular Thickness ◽

Vein Occlusion ◽

Corrected Visual Acuity ◽

The Mean ◽

Web Platform

Aim.Real-lifeevaluation in the management of patients affected by macular edema secondary to retinal vein occlusion.Material and Methods. A retrospective, observational study using theI-Macula Webplatform.Results. Thirty-five patients (37 eyes; 15 females and 20 male) affected by RVO were analysed. At 12 months, there was a statistically significant improvement of best-corrected visual acuity (p=0.0235) and central macular thickness (p<0.0001). The mean change in visual acuity was 8.9 letters. Twenty-seven eyes underwent DEX implant (n=62; mean: 2.29) only. Of these, 8, 4, 14, and 1 eyes underwent 1, 2, 3, and 4 DEX implants, respectively. The remaining 10 eyes were also injected with ranibizumab (n=49; mean: 4.9). At 12 months, 12 eyes (32.5%) presented a dry macula, whereas the remaining 25 eyes (67.5%) still had macular edema. Mean interval between the first and second treatment (T1) and between the second and third treatment (T2) were 5.15 and (T2) 3.7 months, respectively. Where only DEX implants were received, T1 and T2 was 5.1 and 4.9 months, respectively.Conclusions. This study confirms that DEX implants and/or anti-VEGF drugs improve visual acuity and central macular thickness in patients affected by RVO.

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