Predictive factors for functional improvement following intravitreal bevacizumab injections after central retinal vein occlusion

Graefes Arch Clin Exp Ophthalmol. 2017 Mar;255(3):457-462. doi: 10.1007/s00417-016-3471-2. Epub 2016 Sep 8.

Abstract

Purpose: Vision loss in central retinal vein occlusion (CRVO) is mostly caused by macular edema (ME) and can be treated with intravitreal bevacizumab injections. The goal of this study was to identify predictive factors for improvement in visual acuity.

Methods: Three hundred and sixteen eyes of six centres having received intravitreal bevacizumab for ME due to CRVO were enrolled in this multicentre, retrospective, interventional case series. The follow-up time was 24 to 48 weeks. Investigated patient characteristics were pretreatment, duration of CRVO prior to the first injection, initial best-corrected visual acuity (BCVA), baseline central retinal thickness as measured by optical coherence tomography, gender, eye, age, comorbidity with glaucoma, systemic hypertension, or diabetes mellitus.

Results: Multiple regression analysis confirmed the following baseline predictive factors for an increase in visual acuity: low BCVA (p < 0.001), high CRT (p < 0.02), and treatment naïve patients (p = 0.03). None of the other investigated patient characteristics could be identified as prognostic factors for increase in visual acuity (p > 0.1).

Conclusions: Intravitreal injections of bevacizumab in a routine clinical setting effectively improved and stabilized BCVA in CRVO. Our large multicenter study identified initial BCVA, baseline CRT, and pre-treatment as prognostic factors for visual improvement.

Keywords: Bevacizumab; Central retinal vein occlusion; Intravitreal injection; Macular edema; Prognostic factors.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / administration & dosage
  • Bevacizumab / administration & dosage*
  • Dose-Response Relationship, Drug
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Intravitreal Injections
  • Macular Edema / diagnosis
  • Macular Edema / etiology
  • Macular Edema / prevention & control
  • Male
  • Middle Aged
  • Prognosis
  • Recovery of Function*
  • Retinal Pigment Epithelium / pathology
  • Retinal Vein Occlusion / complications
  • Retinal Vein Occlusion / drug therapy*
  • Retinal Vein Occlusion / physiopathology
  • Retrospective Studies
  • Time Factors
  • Tomography, Optical Coherence
  • Visual Acuity / physiology*
  • Young Adult

Substances

  • Angiogenesis Inhibitors
  • Bevacizumab