Does Avastin Work for Retinal Vein Occlusions?

January 6, 2010

As reported in Ophthalmology, a small prospective study finds improvement in patients sustaining retinal vein occlusion (RVO) treated with Avastin.

This study followed 29 eyes injected with 3 consecutive injections of Avastin.  Each treatment was 4 weeks apart.  Visual acuity and macular thickness were followed using ETDRS and OCT.

There were improvements in all parameters.  The vision improved and was maintained to the end of the study at 12 months.  Retinal thickness, as measured with conventional and spectral domain OCT, improved similarly.

Randall V. Wong, M.D.
Retina Specialist Fairfax, Virginia

 

 



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40 Responses to “Does Avastin Work for Retinal Vein Occlusions?”

  • Kathy H.Rockaway Park ny

    Hi,
    i had a BRVO in the end of February. Opthomologist did laser treatment first.now I am
    going for Avastin injections. I had my first one in June, not so bad. the second one hurt and I am really not looking forward to the next but have to. He seen a very slight improvement. Still have hemorrhage and edema.My eyes are very sensitive to light which makes doing anything complicated. If this dosen”t work what is the next step?

  • Marlow,

    Bubbles trapped in the syringe are quite common and the air absorbs in less than a day. In most cases there is no true cause of CRVO.

    Best of luck!

    R. Wong, M.D.
    Retina Specialist

  • My husband developed Central Retinal Vein Occlusion for over 14 months. He has been receiving monthly injections of Avastan which seems to clear up the blurriness each time. The last two injections has left him with many air bubbles that don’t seem to disapate though the doctor’s office said that they should do so within a few days. I did a little research and saw that 2 of the anti veg meds show that the person administering the injection should tap the syringe to release the bubbles prior to injection. I couldn’t find out this info regarding Avastan. Has anyone had this problem. Do the bubbles finally go away? Should we mention the articles and tapping the syringe to the doc for next visit?
    My husband was ruled out for the typical causes of CRVO. Several months prior to the CRVO we had a multch fire near us and the smoke made uall of us ill including my Seeing Eye dog. My husband had a persistent tickle that he could not get rid of and I had to wake him up every night because he was shaking his head so hard. The doctor said that he never heard of anyone getting a CRVO from this but he has been ruled out for everything else. What do you think?

  • Richard deSousa

    I’m under the care of a retinal specialist and he has injected my left eye with Avastin for Branch Retinal Vein Occlusion. I’m aware of what Avastin does for Brain Cancer patients because my brother was injected with Avastin intravenously. But how does Avastin help the eye to recover from BRVO? And how does the blood get removed from the retina?

  • Dadi

    Hi

    I have been diagnosed with BRVO in my left eye four months ago, told that there is no need for laser or anti vegf as the bleeding is not big, my vision in that eye is 20/20 with that little opacity ridden gray spot. Macula thickness was 290-390 depending on what quadrant, not after four months the edema is about 15% lower. So my question is will this gray area dissapear completely as my photofundus is clear?

    Thank you 🙂
    Dadi

  • Richard

    I was diagnosed with CRVO and will get my first Avastin injection today. It creeps me out but I hear there is no pain.
    My doctor said ‘yours is not that bad’ so I feel good about that. Been watching videos and googling and have a lot of questions.
    Can CRVO be reversed?
    I am very upset and will ask doctor questions today.
    Good luck to everyone.

  • I was diagnosed with CRVO and will get my first injection of Avastin next month.
    I have watched quite a few videos on the illness as well as the injection.

    I suffer from anxiety and frankly this scares me. Will I get a sedative before the injection?

    Thank you

    Richard

  • ari

    sounds like your doctor is doing the right thing

  • Francis Pasquini

    Hello, All: I am 69 and developed BRVO in right eye last Oct 2013. Gray splotch appeared to the left of my line of vision. VA has remained 20/20 since the splotch does not block my direct vision. After much agonizing over the possible side effects, I agreed to have the Avastin injection in Oct. No pain and no lasting side effects. I have had 4 injections through Jan 2014. Went to the RS last week, 02/14/14, macular edema has gone down quite a bit; i asked the RS if that damned splotch will ever disappear; she suggested Kenalog but I expressed concern at the risk of cataract formation; she said that one time at a low dose would not cause a cataract; only prolonged injections might possibly lead to cataract. So we agreed to another Avastin next week. After that, we will see if the swelling and splotch completely disappear, and if not, whether I will be willing to risk the Kenalog. I have pretty much ruled out laser due to fear of blind spot formation. God Bless everyone on this site and best of health for your eyes!!

  • ari

    good q. no one really knows. its true that the edema can resolve on its own, so i would wait 3 months to see, but getting avastin immediately is not a bad idea, either, since its so safe.

  • Dr Helena K.

    Please, tell me when it is the best time to start with Avastin for macular edema after BRVO? Is it better to wait a little (some article suggesting about 3 months because the possibility to form the collaterales) or we can start immediatelly with Avastin to prevent chronic macular edema?
    Thank you

  • Tyler Long

    That’s really great that in this survey there were only improvements no harm to the patients.People think that Avastin is a unreliable product. Your post really helped me in understanding the actual result of Avastin. http://compoundingrxusa.com/general-compounding/

  • Dear Janel,

    Avastin may be effective in treating both the neovasularization seen in proliferative diabetic retinopathy and the leaking blood vessels in macular edema.

    Laser, too, is used in both cases.

    Neither is a cure for either the macular edema or proliferative diabetic retinopathy.

    Both must be monitored lifelong.

    Lastly, in my experience, Avastin when used for PDR works quickly and must be repeated. In the long run, the better treatment is achieved with PRP (panretinal photocoagulation) or laser treatment for PDR.

    Avastin, when used for macular edema, may take months to achieve results and is often used instead of or in addition to laser treatment (aka “focal laser”) for macular edema.

    Randall V. Wong, M.D.
    Ophthalmologist, Retina Specialist
    Fairfax, Virginia

  • Janel

    I was diagnosed with proliferative retinopathy several days ago after an angiogram on both eyes. On that same day, I received a shot of avastin in my worst eye. In a couple of weeks i will receive a laser treatment in the worst eye.

    I have read on this board that it can take several months for the avastin to work. Will I need to do this for the rest of my life? I am only 35 years old. Blood Vessels are leaking in both eyes, but vision is distorted in only one eye so far.

    The doctor does not spend much time with me and gives me vague and short answers. Do any of you know what my long term prognosis looks like? Thanks so much.

  • Noelle,

    Your mom’s doctor might be trying to improve any swelling/macular edema secondary to the membrane, but in my opinion, the problem is the macular pucker.

    …that’s why you can’t/won’t find anything to read about Avastin and macular pucker.

    Regarding the injections – they usually don’t hurt. I have found a subset of my patients are very intolerant to the iodine prep used to clean the eye. It can cause a ton of pain lasting about 24 hours and develops right after the injection. Many patients therefore mistakenly feel the actual injection is painful, but it may indeed be the iodine.

    I don’t know if this is exactly the case with your mom and I’m just making a suggestion.

    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, Virginia

  • Noelle Silk

    Back to the question of Avastin injections for macular pucker/epiretinal membrane. Just trying to be a wise consumer of medical services. Mom’s retina specialist is recommending it for her right eye. She previously had the injections for wet AMD in the left eye. From my understanding of how Avastin works, I don’t see how it would affect the pucker, and I have found no info on its use for this condition. The injections DO hurt, I’d rather not subject her to the trauma if Avastin is not really effective against macular pucker. So, should she take the Avastin injections now?

  • Joan Emmrich

    I have received 5 injections of Avastin for retinal vein occlusion. My films did show a slight improvement but the last several show my edema is status quo. My vision has not improved much at all. I do not have pain with the injection, but severe pain and watering in the eye about 4 hours after the injection. This pain will last for about 4-5 hours. Am I allergic to the Avastin or what?

  • Susan Fry

    Hi All, especially Andrea, I know how you feel. I had BRVO last july and thought I had dodged the Avastin bullet…until Dec and had 1 injection then (as my eye had developed oedema) – I don’t care what anyone else says…it hurts (slightly more than a bit!). Had a laser done next month – really weird sensation! No improvement from either treatment. Back to the injections now for the next few months to give the drug a decent shot at helping. I have 20/20 vision, even in that eye, just everything is blurry and distorted above the centre. I actually lost the central vision about 2 weeks ago. Within 3 days of the injection last week, I can already ‘see’ an improvement. Fingers are crossed. I’ve already forgotten the hurt and am ‘looking’ forward to having the next injection so I can take the best possible care of my eyesight. I figure everyone has some health issue they need to deal with that isn’t fun so this is our lot. Just take a deep breath, trust your retinal specialist and take special care of your general health. Good luck and I wish you all best vision.

  • Dear Andrea,

    There are 4 possible treatment options in patients with BRVO;

    1. Do nothing – you might be happy with your vision and don’t fell like anything needs to be done. Left untreated, the BRVO will probably NOT get worse.

    2. Laser treatment if there is swelling…and there usually “macular edema.” All treatments are aimed at minimizing the macular swelling. Laser treatment was the first standardized treatment for this condition starting in the early 1980’s. I often suggest this as the first line of therapy for my patients.

    3. Avastin injections are a great alternative if either the macular edema persists, or, is not treatable with laser. I agree with Ari on that point. I disagree that the injections hurt….they usually do not. Ask you doctor about thoughts after you meet him/her. Also, I doubt you’ll be given an injection that day.

    4. Injection of steroids, in particular Ozurdex, may also be an option and is highly effective in reducing macular edema.

    Best of luck. Keep us updated!

    Randall V. Wong, M.D.
    Retina Specialist
    Fairfax, Virginia

  • ari

    avastin is very safe- thousands of injections have been done, and dozens of studies. it is no longer considered experimental/new, but rather standard of care. only mildly painful and quick. very effective. you may want to wait like 3 months to see if it clears on its own, but i would follow the ophthalmologist’s advice if he favors doing it now. if it were my eye, i would have it done immediately.
    dont sweat it, maam!

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