Tags

Type your tag names separated by a space and hit enter

Bevacizumab versus bevacizumab and macular grid photocoagulation for macular edema in eyes with non-ischemic branch retinal vein occlusion: results from a prospective randomized study.
Graefes Arch Clin Exp Ophthalmol. 2019 May; 257(5):913-920.GA

Abstract

BACKGROUND

The objective of the study was the investigation of the effects of intravitreal bevacizumab (BEV) with or without additional macular grid laser photocoagulation (GRID) for macular edema (ME) secondary to branch retinal vein occlusion (BRVO).

METHODS

Prospective, randomized, monocentric study. Thirty-two patients were included. Initially, all eyes in both groups received three monthly injections of BEV, followed by additional injections if re-treatment criteria were met. In the BEV + GRID group, photocoagulation was performed 2 weeks after the first BEV injection and laser re-treatment was allowed. The follow-up was 38 weeks. Main outcome measures were best-corrected visual acuity (BCVA) and central retinal thickness (CRT). Changes of foveal avascular zone (FAZ) and of retinal ischemia, as well as the number of injections were also evaluated.

RESULTS

Sixteen eyes were randomized into each group. At baseline, BCVA was similar in both groups (BEV + GRID: 20/71; BEV: 20/60; P = 0.51). At 38 weeks, BCVA significantly improved in the two groups (BEV + GRID gain of 9 ± 11.2 letters and 16.25 ± 10.08 letters in the BEV) with no difference between them (P < 0.06). With regard to anatomical findings, initial CRT in BEV + GRID was 496.2 μm ± 138.4 μm and 538.9 μm ± 156.9 μm in BEV (P < 0.1697). At 38 weeks, CRT decreased in both groups significantly, 98.2 μm in the BEV + GRID (P = 0.02) and 141.7 μm in the BEV group (P = 0.01), with no significant difference between groups (P < 0.17). The area of FAZ a significantly increased in both groups (41% (P = 0.04) in BEV + GRID; 35% (P = 0.03) in BEV) during the study and the grade of peripheral ischemia remained unchanged. The mean number of injections was 3.8 (range 3-6) with no significant difference between groups.

CONCLUSIONS

Our data demonstrate a beneficial effect of bevacizumab in ME in eyes with BRVO. A loading phase of three injections led to a significant improvement in vision in both groups, which persisted at week 38. Additional grid laser photocoagulation exhibited no beneficial functional or anatomical effect during the study, nor did it reduce the number of injections. The FAZ area increased significantly in both groups, but overall retinal ischemia did not. Further studies investigating more numerous eyes and longer follow-up are needed to confirm these data.

Authors+Show Affiliations

Department of Ophthalmology, University Medical Center Goettingen, Robert-Koch-Str 40, 37075, Goettingen, Germany. josep.callizo@med.uni-goettingen.de.Augen Praxis Klinik Esslingen, Adler-Str6, 73728, Esslingen, Germany.Department of Ophthalmology, University Medical Center Goettingen, Robert-Koch-Str 40, 37075, Goettingen, Germany.Department of Ophthalmology, University Medical Center Goettingen, Robert-Koch-Str 40, 37075, Goettingen, Germany.Department of Ophthalmology, University Medical Center Goettingen, Robert-Koch-Str 40, 37075, Goettingen, Germany.Department of Ophthalmology, University Medical Center Goettingen, Robert-Koch-Str 40, 37075, Goettingen, Germany.Department of Ophthalmology, University Medical Center Goettingen, Robert-Koch-Str 40, 37075, Goettingen, Germany.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

30610424

Citation

Callizo, Josep, et al. "Bevacizumab Versus Bevacizumab and Macular Grid Photocoagulation for Macular Edema in Eyes With Non-ischemic Branch Retinal Vein Occlusion: Results From a Prospective Randomized Study." Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie, vol. 257, no. 5, 2019, pp. 913-920.
Callizo J, Atili A, Striebe NA, et al. Bevacizumab versus bevacizumab and macular grid photocoagulation for macular edema in eyes with non-ischemic branch retinal vein occlusion: results from a prospective randomized study. Graefes Arch Clin Exp Ophthalmol. 2019;257(5):913-920.
Callizo, J., Atili, A., Striebe, N. A., Bemme, S., Feltgen, N., Hoerauf, H., & Bertelmann, T. (2019). Bevacizumab versus bevacizumab and macular grid photocoagulation for macular edema in eyes with non-ischemic branch retinal vein occlusion: results from a prospective randomized study. Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Fur Klinische Und Experimentelle Ophthalmologie, 257(5), 913-920. https://doi.org/10.1007/s00417-018-04223-9
Callizo J, et al. Bevacizumab Versus Bevacizumab and Macular Grid Photocoagulation for Macular Edema in Eyes With Non-ischemic Branch Retinal Vein Occlusion: Results From a Prospective Randomized Study. Graefes Arch Clin Exp Ophthalmol. 2019;257(5):913-920. PubMed PMID: 30610424.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bevacizumab versus bevacizumab and macular grid photocoagulation for macular edema in eyes with non-ischemic branch retinal vein occlusion: results from a prospective randomized study. AU - Callizo,Josep, AU - Atili,Abed, AU - Striebe,Nina Antonia, AU - Bemme,Sebastian, AU - Feltgen,Nicolas, AU - Hoerauf,Hans, AU - Bertelmann,Thomas, Y1 - 2019/01/04/ PY - 2018/06/05/received PY - 2018/12/18/accepted PY - 2018/12/18/revised PY - 2019/1/6/pubmed PY - 2019/5/2/medline PY - 2019/1/6/entrez KW - Anti-VEGF KW - Bevacizumab KW - Branch retinal vein occlusion KW - Grid laser photocoagulation KW - Macular edema SP - 913 EP - 920 JF - Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie JO - Graefes Arch Clin Exp Ophthalmol VL - 257 IS - 5 N2 - BACKGROUND: The objective of the study was the investigation of the effects of intravitreal bevacizumab (BEV) with or without additional macular grid laser photocoagulation (GRID) for macular edema (ME) secondary to branch retinal vein occlusion (BRVO). METHODS: Prospective, randomized, monocentric study. Thirty-two patients were included. Initially, all eyes in both groups received three monthly injections of BEV, followed by additional injections if re-treatment criteria were met. In the BEV + GRID group, photocoagulation was performed 2 weeks after the first BEV injection and laser re-treatment was allowed. The follow-up was 38 weeks. Main outcome measures were best-corrected visual acuity (BCVA) and central retinal thickness (CRT). Changes of foveal avascular zone (FAZ) and of retinal ischemia, as well as the number of injections were also evaluated. RESULTS: Sixteen eyes were randomized into each group. At baseline, BCVA was similar in both groups (BEV + GRID: 20/71; BEV: 20/60; P = 0.51). At 38 weeks, BCVA significantly improved in the two groups (BEV + GRID gain of 9 ± 11.2 letters and 16.25 ± 10.08 letters in the BEV) with no difference between them (P < 0.06). With regard to anatomical findings, initial CRT in BEV + GRID was 496.2 μm ± 138.4 μm and 538.9 μm ± 156.9 μm in BEV (P < 0.1697). At 38 weeks, CRT decreased in both groups significantly, 98.2 μm in the BEV + GRID (P = 0.02) and 141.7 μm in the BEV group (P = 0.01), with no significant difference between groups (P < 0.17). The area of FAZ a significantly increased in both groups (41% (P = 0.04) in BEV + GRID; 35% (P = 0.03) in BEV) during the study and the grade of peripheral ischemia remained unchanged. The mean number of injections was 3.8 (range 3-6) with no significant difference between groups. CONCLUSIONS: Our data demonstrate a beneficial effect of bevacizumab in ME in eyes with BRVO. A loading phase of three injections led to a significant improvement in vision in both groups, which persisted at week 38. Additional grid laser photocoagulation exhibited no beneficial functional or anatomical effect during the study, nor did it reduce the number of injections. The FAZ area increased significantly in both groups, but overall retinal ischemia did not. Further studies investigating more numerous eyes and longer follow-up are needed to confirm these data. SN - 1435-702X UR - https://www.unboundmedicine.com/medline/citation/30610424/Bevacizumab_versus_bevacizumab_and_macular_grid_photocoagulation_for_macular_edema_in_eyes_with_non_ischemic_branch_retinal_vein_occlusion:_results_from_a_prospective_randomized_study_ L2 - https://dx.doi.org/10.1007/s00417-018-04223-9 DB - PRIME DP - Unbound Medicine ER -