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Morphological and electrophysiological outcome in prospective intravitreal bevacizumab treatment of macular edema secondary to central retinal vein occlusion

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Abstract

Purpose

To evaluate intravitreal bevacizumab (IVB) treatment in patients with central retinal vein occlusion (CRVO) by spectral domain optical coherence tomography (OCT) and electroretinography (ERG).

Methods

Twenty-two CRVO patients were treated with IVB injections and followed for 1 year. Morphological effect of treatment was observed with fluorescent angiography and OCT. Functional effect was followed with best corrected visual acuity (BCVA) and ERG: combined rod-cone response of the standard full-field ERG (dark adapted 3.0 ERG), photopic negative response (PhNR), and pattern ERG (PERG).

Results

Best corrected visual acuity (BCVA) improved by 18.2 letters after 6 months (p ≤ 0.001) and additional 4.7 letters by the 12th month (p ≤ 0.001). The central retinal thickness of 829.8 ± 256.7 μm decreased to 398.8 ± 230 μm (p ≤ 0.001) after 6 months and to 303.7 ± 128.9 μm during the following 6 months (p ≤ 0.001). The total macular volume (14.4 ± 4.2 mm3) decreased to 9.6 ± 3.2 mm3 and 8.5 ± 2.0 mm3 after 6 months and 1 year of treatment, respectively (p ≤ 0.001). Electrophysiological measures improved significantly after 6 months and 1 year of treatment: the a-wave implicit time of dark adapted 3.0 ERG from 25.6 ± 2.3 to 24.1 ± 2.1 and 24.1 ± 2.0 ms (p ≤ 0.01); the PhNR from −5.9 ± 6.6 to −9.4 ± 6.1 and −10.4 ± 4.6 µV (p ≤ 0.05); the PERG P50 amplitude from 0.2 ± 0.3 to 0.9 ± 0.6 and 1.1 ± 0.6 µV (p ≤ 0.001); and N95 amplitude from 0.4 ± 0.6 to 1.2 ± 0.9 and 1.6 ± 0.9 µV (p ≤ 0.001).

Conclusions

Intravitreal bevacizumab (IVB) treatment of macular edema due to CRVO improved standard morphological measures and the electrophysiological function of outer and inner retinal layers, which was most evident in central retina.

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Acknowledgments

The authors wish to thank Mrs. Anja Milenković Kramer, MSc for all the statistical support, Mrs. Marija Jesenšek, Mrs. Ana Jeršin, and Miss Helena Lindič for PERG and PhNR recordings. Mrs. Barbara Klemenc, Miss Anja Hudoklin, Mr. Darko Perovšek, MSc, Mr. Matjaž Miljan and Mr. Mitja Pipan for performing FA and OCT. This study was financially supported by the Slovene Research Agency Grant No. P3-0333 and No. 57/07/09.

Conflict of interest

The authors declare no actual or potential conflicts of interest relevant to this subject matter.

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Authors and Affiliations

  1. General Hospital Novo mesto, Šmihelska 1, 8000, Novo mesto, Slovenia

    Ivana Gardašević Topčić

  2. Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Maja Šuštar, Jelka Brecelj, Marko Hawlina & Polona Jaki Mekjavić

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  1. Ivana Gardašević Topčić
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  2. Maja Šuštar
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  3. Jelka Brecelj
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  4. Marko Hawlina
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  5. Polona Jaki Mekjavić
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Correspondence to Ivana Gardašević Topčić.

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Clinical Trial Registration Number: 57/07/09.

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Gardašević Topčić, I., Šuštar, M., Brecelj, J. et al. Morphological and electrophysiological outcome in prospective intravitreal bevacizumab treatment of macular edema secondary to central retinal vein occlusion. Doc Ophthalmol 129, 27–38 (2014). https://doi.org/10.1007/s10633-014-9445-y

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  • DOI: https://doi.org/10.1007/s10633-014-9445-y

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