PURPOSE: To evaluate the short-term safety and efficacy of intravitreal bevacizumab for the treatment of cystoid macular edema (CME) secondary to uveitis. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Thirteen patients undergoing treatment for recalcitrant uveitic macular edema at one referral center. METHODS: Charts of patients who received one 2.5-mg intravitreal injection of bevacizumab in one eye were reviewed for clinical information including best-corrected Snellen visual acuity (VA), examination findings, optical coherence tomography (OCT) results, and fluorescein angiography results. Kaplan-Meier survival analysis was used to calculate probability success rates. The statistical significance of change in mean retinal thickness and VA was assessed using repeated-measures analysis of variance. MAIN OUTCOME MEASURES: Assessments of changes in best-corrected Snellen VA and OCT retinal thickness were made. RESULTS: Six (46.15%) patients had a decrease in foveal thickness at the end of the follow-up, whereas 5 (38.4%) patients had an improvement of VA by > or =2 lines 84 days or more after the injection. Mean retinal thickness showed a significant decrease over the follow-up (P<0.02). The change in mean logarithm of the minimum angle of resolution VA over the follow-up was not significant (P>0.05). Survival analysis showed that the probability of any improvement in VA increased progressively starting at 6 weeks and reached 81% at 14 weeks. No significant ocular or systemic adverse effects were observed. CONCLUSIONS: These results suggest that a single intravitreal injection of bevacizumab is well tolerated and is associated with short-term improvement in VA and decreased OCT retinal thickness in a considerable proportion of patients with uveitic CME resistant to conventional therapy. Further evaluation of intravitreal bevacizumab for uveitic CME in controlled randomized studies is warranted.
PURPOSE: To evaluate the short-term safety and efficacy of intravitreal bevacizumab for the treatment of cystoid macular edema (CME) secondary to uveitis. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: Thirteen patients undergoing treatment for recalcitrant uveitic macular edema at one referral center. METHODS: Charts of patients who received one 2.5-mg intravitreal injection of bevacizumab in one eye were reviewed for clinical information including best-corrected Snellen visual acuity (VA), examination findings, optical coherence tomography (OCT) results, and fluorescein angiography results. Kaplan-Meier survival analysis was used to calculate probability success rates. The statistical significance of change in mean retinal thickness and VA was assessed using repeated-measures analysis of variance. MAIN OUTCOME MEASURES: Assessments of changes in best-corrected Snellen VA and OCT retinal thickness were made. RESULTS: Six (46.15%) patients had a decrease in foveal thickness at the end of the follow-up, whereas 5 (38.4%) patients had an improvement of VA by > or =2 lines 84 days or more after the injection. Mean retinal thickness showed a significant decrease over the follow-up (P<0.02). The change in mean logarithm of the minimum angle of resolution VA over the follow-up was not significant (P>0.05). Survival analysis showed that the probability of any improvement in VA increased progressively starting at 6 weeks and reached 81% at 14 weeks. No significant ocular or systemic adverse effects were observed. CONCLUSIONS: These results suggest that a single intravitreal injection of bevacizumab is well tolerated and is associated with short-term improvement in VA and decreased OCT retinal thickness in a considerable proportion of patients with uveitic CME resistant to conventional therapy. Further evaluation of intravitreal bevacizumab for uveitic CME in controlled randomized studies is warranted.
Authors: Saloomeh Saati; Rajat N Agrawal; Stan Louie; Gerald J Chader; Mark S Humayun Journal: Graefes Arch Clin Exp Ophthalmol Date: 2009-07-31 Impact factor: 3.117