Treatment Results of Bevacizumab for Macular Edema Secondary to Branch Retinal Vein Occlusion

Abstract

Purpose: To evaluate the results of treatment according to the method of intravitreal injection of bevacizumab for macular edema due to branch retinal vein occlusion (BRVO). Methods: The clinical records of macular edema patients were analyzed retrospectively for a total of 62 eyes of 62 patients who were injected with bevacizumab into the vitreous as the first treatment for BRVO. Best-corrected visual acuity (BCVA), the findings of spectral-domain optical coherence tomography before and after injection, and prognosis-related factors were evaluated for 21 eyes that received the initial three monthly loading treatments and the 41 eyes that did not. Results: Significant improvement in BCVA was observed in the group having received the initial three injections compared with the group who did not receive the injections at 3, 6, and 12 months (<i>p</i> = 0.025, <i>p</i> = 0.019, and <i>p</i> = 0.008, respectively). The central macular thickness (CMT) showed greater improvement in the initial three injections group than the group without at 6 months (<i>p</i> = 0.034). Multivariate regression showed that the duration from the onset, the three loadings, BCVA, disorganization of the retinal inner layer (DRIL), and choroidal thickness were predictors related to visual gain (<i>p</i> = 0.044, <i>p</i> = 0.047, <i>p</i> = 0.004, <i>p</i> = 0.045, and <i>p</i> = 0.034, respectively). Age, three loadings, BCVA, and DRIL were predictors related to final visual acuity (<i>p</i> = 0.045, <i>p</i> = 0.046, <i>p</i> = 0.002, and <i>p</i> = 0.034, respectively). Duration from the onset, CMT, and choroidal thickness were predictors related to CMT improvement (<i>p</i> = 0.042, <i>p</i> = 0.009, and <i>p</i> = 0.015, respectively). Conclusions: In macular edema of BRVO, the initial three monthly intravitreal injections of bevacizumab provided superior treatment outcomes regarding short-term functional and anatomical improvements and long-term functional improvement, compared with methods that did not treat with the initial three monthly injections.