Intravitreal bevacizumab for retinal vein occlusion and early growth of epiretinal membrane: a possible secondary effect?

Br J Ophthalmol. 2011 Mar;95(3):391-5. doi: 10.1136/bjo.2009.177287. Epub 2010 Aug 7.

Abstract

Aims: To report the early development of epiretinal membranes (ERM) in eyes with retinal vein occlusions (RVO) treated with intravitreal bevacizumab and to describe possible mechanisms that may be involved in the growth and contraction of these lesions.

Methods: Retrospective and interventional study that included 25 eyes of 25 patients with RVO (16 eyes with central retinal vein occlusion and nine eyes with branch retinal vein occlusion). After an initial 2.5mg/0.1ml intravitreal bevacizumab injection all patients were followed-up every 6 weeks. Re-treatments were based on visual acuity and optical coherence tomography findings. Results Twenty-five eyes were treated with bevacizumab and followed for 8.3 (range 4.5-13.5) months. Four eyes developed an ERM within 6-7weeks after the administration of bevacizumab. ERM was not associated with further deterioration of visual acuity or metamorphopsia in these patients. A rebound of macular oedema was observed in one patient with ERM and in two other patients. No other side effects were observed.

Conclusions: Intravitreal bevacizumab may be associated with an early growth of ERM in eyes with RVO, although a causative relationship cannot be established. Future randomised clinical trials are necessary to determine the efficacy and safety profile of this novel therapy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / administration & dosage*
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Drug Administration Schedule
  • Epiretinal Membrane / chemically induced
  • Epiretinal Membrane / pathology*
  • Female
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Retinal Vein Occlusion / complications
  • Retinal Vein Occlusion / drug therapy*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Visual Acuity / drug effects

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Vascular Endothelial Growth Factor A
  • Bevacizumab