Comparison of Bevacizumab and Combined Low-dose Bevacizumab and Triamcinolone in Central Retinal Vein Occlusion

PURPOSE: To report the effects and intraocular pressure (IOP) results of intravitreal injection of bevacizumab alone compared with intravitreal low-dose bevacizumab combined with low-dose triamcinolone injection in patients with central retinal vein occlusion. METHODS: In total, 40 eyes of 40 patients diagnosed with central retinal vein occlusion were evaluated. Of these, 20 eyes of 20 patients were injected with intravitreal bevacizumab (1.25 mg/0.05 mL), and 20 eyes of 20 patients were injected with low-dose bevacizumab (0.625 mg/0.025 mL) combined with low-dose triamcinolone (1 mg/0.025 mL). The best corrected visual acuity (BCVA), central macular thickness (CMT), and IOP of treated eyes were measured before injection and at 1 month, 2 months, and 3 months after injection. RESULTS: In both the intravitreal bevacizumab and the low-dose bevacizumab combined with low-dose triamcinolone groups, CMT decreased significantly at 1 month, 2 months, and 3 months after injection (p 0.05). The BCVA, IOP, and CMT at 1 month, 2 months, and 3 months after injection showed no significant differences between the intravitreal bevacizumab group and the low-dose bevacizumab combined with low-dose triamcinolone group (p > 0.05). CONCLUSIONS: The CMT of both groups decreased significantly, and BCVA of both groups increased significantly in patients with central retinal vein occlusion. Injection of low-dose intravitreal bevacizumab combined with low-dose intravitreal triamcinolone may be useful for the treatment of central retinal vein occlusion.

Intravitreal Bevacizumab and Subsequent Trabeculectomy with Mitomycin C for Neovascular Glaucoma with Previous Sutureless Vitrectomy

PURPOSE: To evaluate the efficacy of intravitreal bevacizumab and subsequent trabeculectomy with mitomycin C (MMC) for neovascular glaucoma (NVG) in eyes that underwent previous 23-gauge transconjunctival sutureless vitrectomy (TSV). METHODS: This was a retrospective, comparative, and consecutive case series study. We reviewed the medical records of patients with NVG who underwent trabeculectomy with MMC after intravitreal bevacizumab (1.25 mg/0.05 mL) injection and compared the surgical outcomes according to 23-gauge TSV history. Surgical success was defined as an intraocular pressure (IOP) of ≥6 mm Hg and ≤21 mm Hg without additional glaucoma surgery or loss of light perception. The main outcome measures were postoperative IOP control, visual acuity, and complications. RESULTS: A total of 27 patients (27 eyes) were included; 12 patients with 23-gauge TSV history (TSV group) and 15 patients without vitrectomy history (nonvitrectomized group). The cumulative probability of success after trabeculectomy with MMC was 82.5% and 73.3% after one year for the TSV group and the nonvitrectomized group, respectively (p = 0.523). Mean IOP decreased from 37.3 ± 9.0 mm Hg preoperatively to 12.8 ± 6.2 mmHg at the final visit in the TSV group (p = 0.002). Mean IOP decreased from 40.3 ± 9.7 mm Hg preoperatively to 17.8 ± 11.7 mm Hg at the final visit in the nonvitrectomized group (p = 0.001). Preoperative and final IOP were not significantly different between the two groups. Complications were comparable between the groups. CONCLUSIONS: Intravitreal bevacizumab injection and subsequent trabeculectomy with MMC is an effective method for controlling IOP in patients with NVG associated with sutureless vitrectomy.

Intravitreal Bevacizumab and Subsequent Trabeculectomy with Mitomycin C for Neovascular Glaucoma with Previous Sutureless Vitrectomy

PURPOSE: To evaluate the efficacy of intravitreal bevacizumab and subsequent trabeculectomy with mitomycin C (MMC) for neovascular glaucoma (NVG) in eyes that underwent previous 23-gauge transconjunctival sutureless vitrectomy (TSV). METHODS: This was a retrospective, comparative, and consecutive case series study. We reviewed the medical records of patients with NVG who underwent trabeculectomy with MMC after intravitreal bevacizumab (1.25 mg/0.05 mL) injection and compared the surgical outcomes according to 23-gauge TSV history. Surgical success was defined as an intraocular pressure (IOP) of ≥6 mm Hg and ≤21 mm Hg without additional glaucoma surgery or loss of light perception. The main outcome measures were postoperative IOP control, visual acuity, and complications. RESULTS: A total of 27 patients (27 eyes) were included; 12 patients with 23-gauge TSV history (TSV group) and 15 patients without vitrectomy history (nonvitrectomized group). The cumulative probability of success after trabeculectomy with MMC was 82.5% and 73.3% after one year for the TSV group and the nonvitrectomized group, respectively (p = 0.523). Mean IOP decreased from 37.3 ± 9.0 mm Hg preoperatively to 12.8 ± 6.2 mmHg at the final visit in the TSV group (p = 0.002). Mean IOP decreased from 40.3 ± 9.7 mm Hg preoperatively to 17.8 ± 11.7 mm Hg at the final visit in the nonvitrectomized group (p = 0.001). Preoperative and final IOP were not significantly different between the two groups. Complications were comparable between the groups. CONCLUSIONS: Intravitreal bevacizumab injection and subsequent trabeculectomy with MMC is an effective method for controlling IOP in patients with NVG associated with sutureless vitrectomy.

Pars plana vitrectomy versus three intravitreal injections of bevacizumab for nontractional diabetic macular edema. A prospective, randomized comparative study.

Background: The aim of this study was to compare the effectiveness of pars plana vitrectomy (PPV) and removal of the internal limiting membrane (ILM) with three, monthly, intravitreal bevacizumab (IVB) injections for refractory diabetic macular edema. Materials and Methods: This was a prospective, randomized, comparative, interventional study. Forty‑four patients were enrolled and randomized in two groups. Twenty‑two eyes enrolled in Group I received three IVB injections at monthly interval. Twenty‑two eyes were enrolled in Group II which underwent PPV with ILM removal. The primary outcomes measured were: (1) Best corrected logMAR visual acuity (BCVA) using Snellen’s visual acuity chart. (2) Central macular thickness (CMT) on optical coherence tomography. The secondary outcome measures were: Complication rates like (1) progression of lens opacities, (2) high intraocular pressure needing further treatment/procedure, (3) development of vitreous hemorrhage related to the procedure employed, (4) retinal detachment and (5) severe inflammation/endophthalmitis. Results: In Group I (IVB): 3 (13.6%) eyes showed no change in BCVA; 3 (13.6%) eyes reported decrease in BCVA and 16 (72.8%) eyes showed improvement in BCVA; (P = 0.0181). In Group II (PPV): 4 (18.2%) eyes showed no change in BCVA; 5 (22.7%) eyes showed decrease and 13 (59.1%) eyes showed improvement in BCVA (P = 0.0281). Mean decrease in CMT in IVB group was 108.45 μ, whereas mean decrease in CMT in PPV group was 161.36 μ. No major complications were seen in either group. Conclusion: Posttreatment decrease in CMT was more in PPV group and vision improvement more in IVB group. However, no statistically significant difference between the two methods was found.

lntravitreal Bevacizumab injection combined duplex technique in treatment of neovascular glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

? AlM: To observe the clinical curative effect of intravitreal Bevacizumab injection combined duplex technique in treatment of neovascular glaucoma ( NVG) . ?METHODS:Totally 25 eyes of 25 patients with NVG who underwent intravitreal Bevacizumab injection of 1. 0mg (0. 05mL), after the regression of iris neovascularization, 5 eyes with anterior chamber paracentesis fluid auxiliary controlled intraocular pressure. After 2wk, patients were treated by trabeculectomy and phacomulsification (9 eyes were implanted intraocular lens ) . The changes and complications of intraocular pressure, visual acuity, corneas and neovessels were observed after surgery, and followed up 12mo. ?RESULTS:After injection Bevacizumab in 25 eyes, iris neovascularization of 20 eyes subsided in 3 ~ 5d, and 5 eyes subsided in 7d. After controlling intraocular pressure, count of the corneal endothelial cell were 1 629±226mm2 , and none suffered decompensation of corneal endothelium after two- surgery of trabeculectomy and phacomulsification. After followed up 12mo, intraocular pressure of 20 eyes were controlled in normal range; 2 eyes could control in normal range after treated by a kind of anti-glaucoma medicine and 3 eyes was 34 ~38mmHg after treated by anti- glaucoma medicine. 9 eyes had improved vision after implanted intraocular lens. ?CONCLUSlON:lntravitreal Bevacizumab injection can subside iris and anterior chamber angle neovascularization effectively in a short time and reduce intraocular pressure. lt can also reduce the risk of bleeding during operation or after operation. lntravitreal Bevacizumab injection combined with two- surgery of trabeculectomy and phacomulsification can treat neovascular glaucoma effectively.

Comparison of Intravitreal Bevacizumab Alone Injection and Intravitreal Combination Low-Dose Bevacizumab-Triamcinolone Injection or Diabetic Macular Edema

PURPOSE: To report the effects and intraocular pressure results of intravitreal bevacizumab alone injection compared with intravitreal low-dose bevacizumab combined with low-dose triamcinolone injection in patients with diabetic macular edema. METHODS: In total, 40 eyes of 40 patients diagnosed with diabetic macular edema were evaluated. Of these, 20 eyes of 20 patients were injected with intravitreal bevacizumab (1.25 mg/0.05 mL) and 20 eyes of 20 patients were injected with low-dose bevacizumab (0.625 mg/0.025 mL) combined with low-dose triamcinolone (1 mg/0.025 mL). The best corrected visual acuity (BCVA), central macular thickness, and intraocular pressure of treated eyes were measured before injection and at 1 month, 2 months, and 3 months after injection. RESULTS: In both the intravitreal bevacizumab and the low-dose bevacizumab combined with low-dose triamcinolone groups, BCVA increased significantly at 1 month, 2 months, and 3 months after injection (p 0.05). The BCVA, IOP, and central macular thickness (CMT) at 1 month, 2 months, and 3 months after injection showed no significant differences between the intravitreal bevacizumab group and the low-dose bevacizumab combined with low-dose triamcinolone group (p > 0.05). CONCLUSIONS: The BCVA of both groups increased significantly, and the CMT of both groups decreased significantly in patients with diabetic macular edema. The injection of low-dose intravitreal bevacizumab combined with low-dose intravitreal triamcinolone may be useful for the treatment of diabetic macular edema.

A Case of Intravitreal Bevacizumab Injection for the Treatment of Choroidal Neovascularization in Morning Glory Syndrome

PURPOSE: We report a case of intravitreal bevacizumab injection for the treatment of choroidal neovascularization in morning glory syndrome. CASE SUMMARY: A 51-year-old male visited our hospital for a 1.5-year visual disturbance in his right eye. The patient's best-corrected visual acuity was 0.1 in the right eye. After fundus examination, we found characteristic findings of morning glory syndrome with submacular hemorrhage and serous retinal detachment in the right eye. Optical coherence tomography, fluorescein angiography and indocyanine green angiography were performed for evaluation. Retinoschisis, subretinal fluid, and choroidal neovascularization were detected, and thus bevacizumab was injected in the right eye. After intravitreal bevacizumab injection, retinoschisis was improved, and subretinal fluid was decreased. However, retinal pigment epithelial detachment was newly detected, and serous retinal detachment persisted. After 2 months, a second bevacizumab injection was performed. After these intravitreal bevacizumab injections at 1 and 2 months, visual acuity was 0.4 and 0.6, respectively. Visual acuity improved to 1.0 after 3 months. Visual acuity was maintained for at least 6 months with no relapse of choroidal neovascularization. CONCLUSIONS: The choroidal neovascularization in morning glory syndrome was effectively treated with intravitreal bevacizumab injections.

Comparison of Therapeutic Effect Between Half-Energy Photodynamic Therapy and Intravitreal Bevacizumab Injection in Chronic Central Serous Chorioretinopathy for 12 Months

PURPOSE: In this study we compared the effectiveness between half energy photodynamic therapy (PDT) and intravitreal bevacizumab (IVB) injection for chronic central serous chorioretinopathy (CSC). METHODS: Forty-five eyes of 42 patients diagnosed as chronic CSC from March 2008 to April 2011 were treated with half energy PDT or IVB injection. The subjects were chosen for a retrospective study and analysis was performed on changes in best corrected visual acuity and existence of subretinal fluid, recurrence rate and changes in central macular thickness. RESULTS: Similar improvement of visual acuity was observed in both treatment groups 1 month after treatment and no meaningful difference was found in each stage for both groups (p = 0.001, p = 0.0012, respectively). However, 6 to 12 months after the treatment, the half energy PDT group showed more improvement in visual acuity compared to the IVB injection group (p = 0.019, p = 0.043, respectively). Nineteen out of 21 cases showed full recovery of subretinal fluid in the half energy PDT group with an average treatment period of 1.3 +/- 0.8 months and 7 out of 24 cases showed full recovery in the IVB injection group with an average treatment period of 3.2 +/- 2.8 months. There was a single case of recurrence in the half energy PDT group and 4 in the IVB injection group. The half energy PDT group showed a meaningful decline in central macular thickness at 1, 3, and 6 months after treatment (p = 0.001, p = 0.005, p = 0.007, respectively) compared to the IVB injection group and showed numerous cases with decline in central macular thickness below the 2 standard deviation from normal values (p = 0.002). CONCLUSIONS: Both half energy PDT and IVB injection were effective for the treatment of chronic central serous chorioretinopathy. However, the half energy PDT group comparatively showed better anatomical and functional outcomes. The thinning of central macular thickness below normal value was also observed, thus careful choice of treatment is necessary for patients with chronic central serous chorioretinopathy.

Combined Therapy of Bevacizumab and Grid Photocoagulation for Macular Edema in Branch Retinal Vein Occlusion

PURPOSE: To evaluate clinical outcomes of a combined therapy of intravitreal bevacizumab and grid laser photocoagulation for macular edema in branch retinal vein occlusion (BRVO). METHODS: In the present retrospective study, medical records of patients who were treated with intravitreal bevacizumab injection for macular edema due to BRVO were reviewed. The eyes were divided into 2 groups, the combined therapy group of intravitreal bevacizumab and grid laser photocoagulation, and the monotherapy group of intravitreal bevacizumab. Visual acuity and central subfield macular thickness were investigated at 1, 2 and 6 months. Recurrence rate was compared between the 2 groups. RESULTS: Among 49 eyes, 18 eyes underwent macular grid photocoagulation and 31 eyes did not receive laser treatment. Laser photocoagulation was performed at 1.2 months after injection on average. Visual acuity improved significantly at 2 and 6 months in the combined therapy group, and at 1, 2 and 6 months in the monotherapy group. Macular thickness decreased significantly compared to baseline at all visits in both groups. There was no significant difference in visual acuity and foveal thickness between the 2 groups. Recurrence at 6 months was significantly less frequent in the combined therapy group (3 eyes, 17%) then in the monotherapy group (14 eyes, 45%, p = 0.046). CONCLUSIONS: Combined grid photocoagulation after intravitreal bevacizumab injection lowered the recurrence rate of macular edema complicated with BRVO.

Effects of Intravitreal Bevacizumab Injection in 3 Types of Macular Edema Secondary to Branch Retinal Vein Occlusion

PURPOSE: To compare the effects of intravitreal bevacizumab injection (IVB) in 3 types of macular edema secondary to branch retinal vein occlusion (BRVO). METHODS: Patients with macular edema secondary to BRVO with at least 1-year follow-up after IVB were included in the present retrospective study. The authors classified the macular edema into 3 types according to OCT findings: diffuse macular edema (type 1), cystoid macular edema (type 2), and serous retinal detachment (type 3). The clinical outcome indicators were best corrected visual acuity, central macular thickness (CMT), and total number of injections. RESULTS: The total injection number was significantly higher in type 2 than type 3 (p = 0.02). Changes in CMT were significantly different between type 2 and type 3 (p = 0.03). CMT decreased significantly after IVB in all types of macular edema. CONCLUSIONS: Morphologic classification of macular edema with OCT is useful for predicting efficacy of IVB in macular edema secondary to BRVO.

A Case of Intravitreal Bevacizumab Injection for the Treatment of Choroidal Neovascularization in Angioid Streaks

A 56-year-old Korean woman presented with decreased visual acuity of the right eye. She had a history of two photodynamic therapy treatments for choroidal neovascularization (CNV) due to angioid streaks in her left eye with central scarring and low visual acuity. She was diagnosed with subfoveal CNV due to angioid streaks in her right eye and treated with six intravitreal bevacizumab (1.25 mg / 0.05 mL) injections over one year. Best corrected visual acuity improved from 20 / 125 at baseline to 20 / 50 at the final visit. The area of CNV had changed into a fibrotic scar by the final visit, and fluorescein angiography and indocyanine green angiography revealed no evidence of leakage. Optical coherence tomography showed that central macular thickness decreased from 311 microm at baseline to 203 microm with complete resolution of subretinal and intraretinal fluid at the final visit. Intravitreal bevacizumab for CNV associated with angioid streaks prevented the progression of disease and resulted in the improvement of visual acuity after one year of follow-up in our patient.

Effect of 23-gauge Sutureless Vitrectomy & Preoperative Bevacizumab on Results of Diabetic Vitrectomy

PURPOSE: To investigate the results of 23-gauge sutureless vitrectomy and preoperative bevacizumab in diabetic retinopathy cases. METHODS: A total of 212 eyes received pars plana vitrectomy by a single surgeon for proliferative diabetic retinopathy and were followed up for at least 6 months. The change of visual acuity and operative complications among the 20-gauge vitrectomy (group I, 86 eyes), 23-gauge vitrectomy (group II, 30 eyes), and 23-gauge vitrectomy with preoperative intravitreal bevacizumab (IVB) injection (group III, 96 eyes) were retrospectively analyzed. RESULTS: One month postoperatively, visual improvement was better in groups II and III than in group I. Three months postoperatively, visual improvement was better in group III than in groups I and II. Six months postoperatively, visual improvement in group III was better than in group I, but there was no significant difference between group II and III. Intraoperative retinal breaks and postoperative vitreous hemorrhage were less common in group III than in groups I and II. CONCLUSIONS: In patients with proliferative diabetic retinopathy, 23-gauge sutureless vitrectomy showed faster visual recovery compared with 20-gauge vitrectomy, and vitrectomy with preoperative bevacizumab had less intraoperative and postoperative complications than vitrectomy without preoperative bevacizumab.

Clinical Course after Intravitreal Bevacizumab Injection in Ischemic Central Retinal Vein Obstruction

PURPOSE: To determine the clinical outcome of intravitreal bevacizumab injection in patients with ischemic central retinal vein obstruction (CRVO). METHODS: The present study was conducted retrospectively on 56 eyes of 56 patients who were diagnosed with CRVO and classified according to ischemic and non-ischemic type and underwent an intravitreal bevacizumab injection. The present study measured changes in visual acuity and central macular thickness, neovascularization in the anterior segment, development of neovascular glaucoma and other clinical complications. RESULTS: The average number of bevacizumab injections in both groups was 2.07 and 1.62 in the ischemic type. No patients developed neovascular glaucoma in the non-ischemic type group, 14 of 26 eyes in the ischemic type group developed neovascular glaucoma and the mean time to diagnosis was 28.75 weeks. log MAR visual acuity of the ischemic type group prior to injection was 1.56 +/- 0.65 on average which improved to 1.44 +/- 0.97 (p = 0.45). CONCLUSIONS: Intravitreal bevacizumab injection improves the condition of cystic macular edema clinically, but does not affect the development of neovascular glaucoma and improvement of visual acuity in ischemic type CRVO.

Electroretinographic Assessment of the Retinal Function during Intravitreal Bevacizumab Injections in Central Retinal Vein Occlusion

PURPOSE: To investigate the changes of electroretinogram (ERG) at baseline and during the first 3 injections of intravitreal bevacizumab in central retinal vein occlusion (CRVO) patients. METHODS: Thirteen eyes of 13 CRVO patients who received 3 injections of intravitreal bevacizumab at 6-week intervals and who could be examined for visual acuity, optical coherence tomography and ERG at 4 weeks after each injection were included in the present study. In addition, the ERG results of the unaffected fellow eyes group at 4 weeks after each injection were compared with the CRVO eyes group. RESULTS: Amplitudes of rod b wave, a and b waves of maximal combined response and cone response, oscillatory potentials and 30-Hz flicker significantly decreased in the CRVO eyes group than the fellow eyes group at 4 weeks after each injection (p 0.05). CONCLUSIONS: After intravitreal bevacizumab injection, macular functions significantly improved and amplitudes of all ERG parameters gradually increased in CRVO patients.

The Effects of Intravitreal Bevacizumab Injection According to the Type of Diabetic Macular Edema

PURPOSE: To investigate the effects of intravitreal bevacizumab injection on diabetic macular edema (DME) of different types classified using Optical Coherence Tomography (OCT). METHODS: A total of 82 eyes with refractory DME were enrolled. The DME was classified into diffuse, cystoid, or serous type based on the OCT findings. All cases had received an intravitreal injection of 1.25 mg bevacizumab each month for three months. Foveal thickness, macular volume, and best corrected visual acuity (BCVA) were measured before and one month after the injection, and the interval changes in these parameters were compared. RESULTS: The types of DME were classified as follows: diffuse macular edema 50%, cystoid macular edema 31.7%, and serous macular detachment 18.3%. Foveal thickness and total macular volume after intravitreal bevacizumab injection decreased in all types, and the cystoid and serous types showed better response than did the diffuse type with regard to foveal thickness. However, there were no significant differences in the extent of the change in total macular volume or BCVA among the three types of DME. CONCLUSIONS: There were differences in the therapeutic effects of intravitreal bevacizumab injection among the different types of DME classified using OCT. These differences may be associated with the stabilizing effect of the bevacizumab. This effect was stronger with regard to vascular permeability, the primary factor in the pathogenesis of the cystic and serous types, than with regard to leakage from the microaneurysm, the primary factor in the pathogenesis of the diffuse type. Practical application of bevacizumab to eyes with different DME types will help in further evaluating intravitreal bevacizumab injection as a treatment option for DME.

Serous Retinal Detachment Following Combined Photodynamic Therapy and Intravitreal Bevacizumab Injection

We report a case of serous retinal detachment following combined photodynamic therapy (PDT) and intravitreal bevacizumab injection in subfoveal choroidal neovascularization (CNV).

The Effect of Intravitreal Bevacizumab Injection in Eales' Disease

PURPOSE: To report on 2 cases of Eales' disease that were successfully regressed with laser photocoagulation and intravitreal bevacizumab (Avastin; Genetech, Inc, San Francisco, California, USA) injection. CASE SUMMARY: Two male patients (30 years and, 40 years of age,) with a history of recurrent vitreous hemorrhage were diagnosed with Eales' disease. The 2 patients had peripheral retina neovascularization and active phlebitis in fundus fluorescein angiography. No other findings were observed in their eyes in the general examination. Scatter laser photocoagulation and intravitreal bevacizumab injection were performed. After 1 month follow-up, neovascularization completely regressed. There was no complication or recurrent vitreous hemorrhage at the 1 year follow up. CONCLUSIONS: Intravitreal bevacizumab injection, as combination treatment of laser photocoagulation, may be helpful in the regression of neovascularization due to Eales' disease.

Effects and Prognostic Factors of Intravitreal Bevacizumab Injection on Choroidal Neovascularization from Age-Related Macular Degeneration

PURPOSE: To investigate the effects and prognostic factors related to intravitreal injection of bevacizumab on patients with subfoveal choroidal neovascularization secondary to age-related macular degeneration. METHODS: The medical records of patients who received 3 consecutive intravitreal injections of bevacizumab (1.25 mg/0.05 ml, 6 weeks interval) for subfoveal choroidal neovascularization secondary to age-related macular degeneration and followed up for more than 12 months were reviewed (a total of 31 eyes; male, 20; mean age, 72.3+/-7.5 years). Baseline best corrected visual acuity, foveal thickness, and total macular volume were compared with those after 1, 4, and 12 months. The therapeutic effects were investigated with regard to factors such as age, sex, initial visual acuity, lesion size, subtypes of choroidal neovascularization, pigment epithelial detachment, submacular hemorrhage, and previous history of photodynamic therapy. RESULTS: Initial visual acuity (logMAR), foveal thickness, and total macular volume were 0.74+/-0.49, 320+/-88 microm and 9.50+/-2.99 mm3, respectively. Visual acuity improved to 0.68+/-0.61 (p=0.012), and foveal thickness and total macular volume decreased to 218+/-69 microm and 6.32+/-0.71 mm3 (p<0.001), respectively, at 12 months. Visual improvement was achieved less often in patients who were 75 years or older and who had lesions 3 disc areas or greater and relatively good initial vision at 12 months. CONCLUSIONS: Intravitreal bevacizumab injection has beneficial effects for patients with subfoveal choroidal neovascularization secondary to age-related macular degeneration with regard to function and anatomy. However, it should be noted that visual improvement may be limited in older patients with larger lesions and good initial vision.

Electrophysiological and Morphological Changes After Intravitreal Bevacizumab Injection with Macular Edema or Choroidal Neovascularization

PURPOSE: To evaluate the functional and anatomical statuses of macula with multifocal electroretinogram (mfERG) and optical coherence tomography (OCT) for the treatment of patients with macular edema after intravitreal bevacizumab injection. METHODS: Patients were injected with intravitreal bevacizumab (1.875 mg/0.075 ml) for macular edema with choroidal neovascularization (CNV), diabetic retinopathy and retinal vein occlusion. RESULTS: A total of 120 eyes (96 patients) were diagnosed with diabetic retinopathy, CNV with age-related macular degeneration and retinal vein occlusion. Visual acuity improved from logMAR 0.85+/-0.39 to 0.54+/-0.38 after intravitreal bevacizumab injection. The implicit time of P1 and N2 in mfERG decreased, and the amplitude of P1 showed a statistically significant increase. Central macular thickness decreased from 374.4+/-135.2 micrometer to 249.0+/-72.0 micrometer. CONCLUSIONS: After intravitreal bevacizumab injection, functional and anatomical statuses of mfERG and OCT improved. This study demonstrates a method for utilizing mfERG to assess the effectiveness of treatments such as bevacizumab.

Intravitreal Bevacizumab for Treatment of Diabetic Macular Edema

PURPOSE: To evaluate the effect of intravitreal bevacizumab on visual function and retinal thickness in patients with diabetic macular edema (DME). METHODS: Thirty eyes of twenty-eight patients (mean age, 57.9+/-13.8 years) with DME were included in this study. Complete ophthalmic examination, including determination of best-corrected visual acuity (BCVA), stereoscopic biomicroscopy, and retinal thickness measurement by optical coherence tomography (OCT), was done at baseline and at each follow-up visit. All patients were treated with a 0.05 mL intravitreal injection containing 1.25 mg of bevacizumab. RESULTS: All patients completed 3 months of follow-up with a mean follow-up period of 5.26+/-2.39 months. The mean BCVA at baseline was 0.73+/-0.36 logMAR, which significantly improved to 0.63+/-0.41 (p=0.02), 0.58+/-0.36 (p=0.003), and 0.61+/-0.40 logMAR (p=0.006) at 1 week, 1 month, and 3 months. Final BCVA analysis demonstrated that 15 eyes (50%) remained stable and 12 (40%) improved > or =2 lines on BCVA. The mean central retinal thickness was 498.96+/-123.99 microm at baseline and decreased to 359.06+/-105.97 (p<0.001), 334.40+/-121.76 (p<0.001), 421.40+/-192.76 microm (p=0.035) at 1 week, 1 month, and 3 months. No ocular toxicity or adverse effects were observed. CONCLUSIONS: Intravitreal bevacizumab injection resulted in significant improvement in BCVA and central retinal thickness as early as 1 week after injection in patients with DME, and this beneficial effect persisted for up to 3 months. However, the slight reduction in this improvement at 3 months suggests that repeated bevacizumab injections might be necessary. To evaluate the long-term safety and efficacy, further prospective randomized controlled clinical trials will be needed.