Intravitreal bevacizumab for retinal vein occlusion and early growth of epiretinal membrane: a possible secondary effect?
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Joaquin Marticorena1, Mario R Romano, Heinrich Heimann
1Instituto Tecnológico de Oftalmología, Hospital Nuestra Señora de la Esperanza, Av de las Burgas 2, Santiago de Compostela, Spain. jmarticorena@gmail.com
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.
Insights
Intravitreal bevacizumab treatment for retinal vein occlusion (RVO) may be linked to early epiretinal membrane (ERM) development. Further research is needed to confirm this association and evaluate the therapy
Area of Science:
- Ophthalmology
- Retinal Diseases
- Pharmacology
Background:
- Retinal vein occlusion (RVO) is a significant cause of vision loss.
- Intravitreal anti-VEGF agents are a common treatment for RVO-related complications.
- Epiretinal membranes (ERMs) can form after various retinal insults.
Purpose of the Study:
- To investigate the early occurrence of ERMs in RVO patients treated with intravitreal bevacizumab.
- To explore potential mechanisms behind ERM formation and contraction post-treatment.
Main Methods:
- Retrospective interventional study of 25 eyes with RVO (central and branch).
- Patients received intravitreal bevacizumab (2.5mg/0.1ml) with follow-up every 6 weeks.
- Re-treatment decisions based on visual acuity and optical coherence tomography (OCT).
Main Results:
- Four out of 25 eyes developed ERMs within 6-7 weeks of bevacizumab injection.
- ERM development was not correlated with worsening visual acuity or metamorphopsia.
- Macular edema recurrence occurred in 3 patients (1 with ERM, 2 without).
Conclusions:
- A potential association exists between intravitreal bevacizumab and early ERM development in RVO.
- Causality cannot be definitively established from this study.
- Randomized trials are required to confirm efficacy and safety.