Intravitreal bevacizumab for macular edema due to central retinal vein occlusion: perfused vs. ischemic and early vs. late treatment.

Purpose/aims: This study investigates the efficacy of intravitreal bevacizumab (IVB) for cystoid macular edema (CME) secondary to central retinal vein occlusion (CRVO). Subgroup analysis was performed comparing early (within 90 days of CRVO onset) and late treatment (after 90 days) as well as perfused and ischemic subgroups.

Materials And Methods: Retrospective review of 48 consecutive eyes with CRVO treated with IVB was performed. Data collected at various time points included best corrected visual acuity (BCVA), central foveal thickness (FT) on optical coherence tomography (OCT), perfusion status on fluorescein angiography (FA), and complications.

Results: Mean initial BCVA was 20/288 compared to 20/214 at 12 months (p=0.07) and 20/204 (p=0.03) at final follow-up. Initial mean central FT was 591 micrometers compared to 339 micrometers at 12 months (p=0.003). Mean follow-up was 10.5 months, and mean number of injections was 3.7. After IVB, no significant difference in BCVA gain or edema resolution on OCT was noted between the early and late treatment groups or between the perfused and ischemic subgroups.

Conclusions: IVB improves foveal thickness in eyes with CRVO, but this does not always correlate with visual recovery. No difference in efficacy was observed for IVB treatment of perfused versus ischemic CRVO or when used for early versus late treatment.