Intravitreous Injection With Avastin Therapy For Macular Edema

Objective:To evaluate the efficacy of intravitreal injection with Avastin for macular edema associated with central retinal vein occlusion (CRVO), branch retinal vein occlusion (BRVO) and diabetic retinopathy (DR).Methods:Diagnosed by binocular indirective ophthalmoscopy, optic coherent tomography (OCT) or (and) fundus fluorescein angiography (FFA), 69 patients (76 eyes) with macular edema caused by CRVO,BRVO and DR were intravitreously injected with Avastin 1.25mg/0.05ml. During 2-13months follow-up period, the visual acuity, intraocular pressure, manifestation of lens and fundus were observed, vascular leakage was detected by FFA, and the retinal thickness was examined by OCT.Results:The differences of LogMAR best corrected visual acuity (BCVA) between before injection and at 1w, lm,2m and 3m after injection were statistically significant in all of the three groups. The LogMAR BCVA among the four time points after injection (1w,1m,2m,3m) had no significant difference in CRVO group. In BRVO group, the LogMAR BCVA at lm after injection had significant difference from 2m and 3m after injection (t=-2.282,-3.000,P=0.031,0.006,both P<0.05). For the patients of DME, the LogMAR BCVA was 0.57±0.32 at 1w after injection, comparing with the LogMAR BCVA at lm after injection (0.54±0.27), the difference was statistically significant (P<0.05). The statistics of central macular thickness (CMT) at 1m,2m,3m after injection were significant differences compared with before injection in each of the three groups. The CMT at the four time points after injection were significantly thinner than that before injection in all of the three groups. The CMT at lm and 3m after injection were (337.57±35.851)μm and (375.11±23.219)μm in CRVO group, which had a significant difference (P<0.05). The CMT was no significant difference at each time point after injection in the group of BRVO and DR. OCT image showed that after injection macular retinal thickness was becoming thinner. FFA showed that after injection macular fluorescein leakage decreased. The LogMAR BCVA decreased again in eleven patients at 2 month after injection. The FFA showed macular edema recurrented. Given the same dose Avastin intravitreal injection again, the visual acuity of these patients raised at 1 month after injection. There was no significant increase in intraocular pressure. There were no cataract, endophthalmitis, retinal detachment and other serious complications happened during the study.Conclusions:Avastin intravitreal injection is effective for ME caused by CRVO, BRVO and DR. Repeated avastin intravitreal injection were needed for retaining therapeutic effect in parts of the patients. There were no serious ocular and systemic complications occurred during our study.