Avastin ® (bevacizumab) has been found effective in treating macular edema in patients with branch retinal vein occlusion as compared to central retinal vein occlusion.  The study extended over a 12 month period and measured vision , central retinal thickness and vascular perfusion.  Injections were delivered monthly for 3 months, then as indicated per protocol.  In most patients, the macular edema was reduced, central retinal thickness decreased and vision in improved.  There was; however, a significant rebound effect.  Approximately 20% of patients got worse after initial improvement.  The data for CRVO was not conclusive, but indicates that bevacizumab may not be as effective in treating macular edema in CRVO as with BRVO.

This is a common scenario that we commonly face when attempting to define the appropriateness of new therapies.  Several other drugs, such as Kenalog ®, have taken this path, too.  For a time, we were using Kenalog for everything from choroidal neovascular membranes to macular edema.  It is not ever clear, until proper randomized tests are completed, whether a new therapy actually works.  What is clear is that the accepted treatment for macular edema created by branch retinal vein occlusions is not good enough and that we are striving to find a better treatment.  This study indicates hope that we will find a better treatment.  At the very least, as we sift through the data, we can offer more hope for our patients.

Read full article. ^[1]

The glass is half full.

Randall V. Wong, M.D.
Retina Specialist
www.TotalRetina.com ^[2]