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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Comments
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My doctor wants to use AVASTIN-{OFF-Label} to treat my Macular Pucker. Macular Pucker is present in both eyes. I’ve read what I can about its use with macular degeneration but nothing specific regarding Macular Pucker. Is there any study available ? Thank you.
Not sure if I am aware of a study. Macular pucker can cause macular edema by physical disruption of the retinal surface. The macular edema caused would be secondary to this “traction.”
In cases of macular pucker, unlike other cases of maculara edema, the retinal vessels are normal.
R. Wong, M.D.
I just had my first shot of avastin today for retinal vein occlusion. I’ll let you know how it works. It was a scary thought but no pain was involved, or very little. My eye has been watering a bit. The whole thing kind of freaked me out, but really was not too bad. I hope it helps as I have a blurry spot in my left eye. I have always taken my vision for granted.
If someone has a retinal vein occlusion, and tries Avastin, what are the possible complications?
How many shots would be given?
How quickly would someone notice improvement?
complications are practically nil. should see improvement in about a month. you may need repeated injections over the next 6-12 months if the improvement starts to wane. if avastin fails, consider kenalog.
I agree with Dr. Weitzner.
The combination of drugs, such as Avastin, and streroids (Kenalog) seen to be a pretty good treatment regimen.
An alternative, with/without, Avastin is an implant called Ozurdex. Ozurdex releases steroid for about 4-6 months and is indicated for RVO.
All the best,
Randy
Thank you Dr.’s Weitzner and Dr. Wong (do either of you see patients either for a consult or for treatment)?
My friend also has glaucoma, in addition to RVO. Would Avastin and possibly kenalog still be your suggested protocol?
Looking for the best choice, for the best outcome, with the least complications.
One other question, is Avastin treatment ‘special’ in the sense that it should be given by someone who is much more familiar with it, such as yourselves? or has it become ‘standard treatment’ now?
Annette
Got a branch retinal vein occlusion , been observed for 12 months with two bouts of laser done over that period . My vision is twisted and very poor in that eye . I have received a shot of avastin in that eye 5 days ago and clarity is better . Still twisted but am due to get another in 4 weeks … Fingers crossed as it’s been a hard 12 months …. Richo
Dear Richo,
I wish you the best of luck. I continue to be amazed at how effectively, and completely, certain patients improve with Avastin for BRVO.
Thanks for your comment!
Randy
my left eye was getting harder to focus about 4yrs ago. my welding was getting poorer because i could not focus. I thought it was my prerscription on my glasses,not. I was driving one day and all of a sudden a black spot shows up and i have terrible time with depth perception. 5 days later i get Avastin into the eye. The Dr said it was a leaking blood vessel. they dont know what causes it. My sight was measured at 2070/20 and 20/20 on the right.eye. about a week later the bad eye was down to 270/20 and the sight and black spot got better. 4 wks later i got another shot and i went to another dr. for a second opinion . they said my Dr was doing the best and latest to help the eye. I went for the third injection. the spot has been clearing up but i wanted the inj. in 3 wks not 4. He agreed. tomorrow i get another. this has been going on for 3 months. I still have the spot but not as bad and seems to be getting clearer. reading seems to be improving but very slowly. ok, that’s it ……………..TS
I have been treated for approximately three three for BRVO with injections of Avastin every 5-6 weeks. The vision in my left eye is somewhere between 300-400/20. I do not see much improvement between the injections. I did under go surgery which was unsuccessful. I for a time also received injections using Kenilog. I developed a cataract in the left eye and had surgery. What happens if I stop having the injections?
if avastin/kenalog injections do not help you by now, most likely it never will. consider a second opinion from a retina specialist re: continuing with these injections. what surgery did you undergo?
My husband had a retinal vein occlusion last autumn. He had an injection of avastin just before Christmas and his sight improved enormously. However, it’s now 7 weeks after the injection and his sight is just starting to go wrong again. How long can he go on having injections, and do they begin to have a lasting effect? He’s 62.
typically a patient will need several injections- monthly for the first 3 months, then as needed thereafter. he needs to go back to the ophthalmologist for an oct scan and likely repeat injection.
I experienced a central vein occlusion/ left eye almost 1 year ago. I initially had 3 injections of Avastin, each 1 month apart. My Dr. then tried the steroid shot, but it only lasted 3 months instead of the 8 to 12 hoped for. I have just received my 4th shot in the latest series. These shots have been my only answer to maintaining my vision. My question is how long can I continue to get Avastin injections? I also had a branch retinal vein occlusion in my other eye 10 years ago for which there wasn’t a treatment for at that time. I have very limited useful vision in that eye. So as you see I very much need to maintain my vision in my left eye.
Dear Diane,
It has been my experience that we can easily give intravitreal injections, such as Avastin, on a monthly basis for at least several years.
Have you had any experience with Ozurdex or other steroids?
Randy
you can get many injections- the risk is very small. keep getting as many as the doctor suggests.
I have been having injections of Avastin since 2007 and have maintained very good eyesight for 5 years , injections have been varied from 6 – 10 weeks although in the last 12 months they have not been stretched out past 7 weeks…..went to the doc yesterday for the injection and he seems to think that my sight will no longer be maintained and will be reduced.
My question is do I have any other options available as his advice was that for this condition Avastin is the best…………………
you may want to consider kenalog injection
I hate being a newby but I am kind of freaked out right now. Yesterday, I was diagnosed with Cystoid Macular Edema (Eye Condition) primary and Branch Retinal Vein Occusion. I’m going to be 66 in a week and a half and I happen to have beautiful eyes (as I bet most of you do). My doc referred me to a group and she told me all about Avastin. Just how many studies have been done using it for eyes? Any long-term studies? I know I’ll find out when I go to the doctor, but I want to be prepared. Am I likely to have an Avastin shot the first visit. I’m trying not to panic–I’d like to understand what a conservative course of action might be for me.
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!
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
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.