Anti-VEGFs for Macular Edema?
Anti-VEGFs for Macular Edema?
The pathophysiology of macular edema has both inflammatory and vascular permeability components. Vascular endothelial growth factor (VEGF) has been demonstrated to increase vascular permeability leading to macular edema. Furthermore, retinal vein occlusion causes an increase in VEGF. Therefore, therapy has been focused on inhibiting VEGF; bevacizumab is 1 type of anti-VEGF therapy.
Pai SA, Shetty R, Vijayan PB, et al
Am J Ophthalmol. 2007;143:601-606
In this case series, 21 patients received an intravitreal injection of bevacizumab 1.25 mg for retinal occlusive disease with macular edema (9 with central retinal vein occlusion, 12 with branch retinal vein occlusion). At 1 month after injection, the initial mean visual acuity of 20/381 improved to 20/135. Retinal thickness decreased from 647.81 micrometers (mcm) to 293.43 mcm 1 month after treatment. There were no changes in visual-evoked potential or electroretinography.
This study demonstrates good short-term efficacy and safety in treating macular edema related to retinal occlusion. This protocol should be followed in addressing long-term therapy safety, including multiple injections, which may lead to changes in retinal function measured with visual-evoked potential or electroretinography. A combination of therapies, including anti-inflammatory and anti-VEGF, may prove beneficial in macular edema therapy.
Abstract
Introduction
The pathophysiology of macular edema has both inflammatory and vascular permeability components. Vascular endothelial growth factor (VEGF) has been demonstrated to increase vascular permeability leading to macular edema. Furthermore, retinal vein occlusion causes an increase in VEGF. Therefore, therapy has been focused on inhibiting VEGF; bevacizumab is 1 type of anti-VEGF therapy.
Clinical, Anatomic, and Electrophysiologic Evaluation Following Intravitreal Bevacizumab for Macular Edema in Retinal Vein Occlusion
Pai SA, Shetty R, Vijayan PB, et al
Am J Ophthalmol. 2007;143:601-606
Summary
In this case series, 21 patients received an intravitreal injection of bevacizumab 1.25 mg for retinal occlusive disease with macular edema (9 with central retinal vein occlusion, 12 with branch retinal vein occlusion). At 1 month after injection, the initial mean visual acuity of 20/381 improved to 20/135. Retinal thickness decreased from 647.81 micrometers (mcm) to 293.43 mcm 1 month after treatment. There were no changes in visual-evoked potential or electroretinography.
Comments
This study demonstrates good short-term efficacy and safety in treating macular edema related to retinal occlusion. This protocol should be followed in addressing long-term therapy safety, including multiple injections, which may lead to changes in retinal function measured with visual-evoked potential or electroretinography. A combination of therapies, including anti-inflammatory and anti-VEGF, may prove beneficial in macular edema therapy.
Abstract
