Bevacizumab Treatment for Acute Branch Retinal Vein Occlusion Accompanied by Subretinal Hemorrhage

Abstract

Purpose: The purpose of this study was to compare the efficacy of intravitreal bevacizumab (IVB) in the treatment of acute (<3 months [mo]. duration) macular edema (ME), with or without subretinal hemorrhage (SRH), resulting from branch retinal vein occlusion (BRVO).

Materials and methods: We conducted a retrospective review of 33 consecutive patients (n = 33 eyes) with ME caused by acute BRVO. All patients received an injection of IVB at baseline examination. All patients were followed monthly, with administration of additional IVB injections if there was persistent or recurrent ME. Specific patterns of ME were investigated using spectral-domain optical coherence tomography (SD-OCT).

Results: SD-OCT revealed serous retinal detachments in the fovea of 15 eyes, 10 of which had accompanying foveal SRH. Based on initial detection of foveal SRH, patients were divided into SRH-negative (n = 23 eyes) or SRH-positive (n = 10 eyes) groups. Initial best-corrected visual acuity (BCVA) did not differ between the two groups. In the SRH-negative group, both BCVA and central macular thickness (CMT) improved significantly after IVB injections (mean, 2.3 injections) at the 6-mo. follow-up examination. In the SRH-positive group, there was no significant improvement in BCVA after IVB injections (mean, 2.0 injections), although there was a significant decrease in CMT. The final BCVA of the SRH-positive group was significantly poorer than that of the SRH-negative group (p = 0.001).

Conclusion: The presence of foveal SRH may be a negative predictor of IVB treatment outcomes for BRVO patients with ME.

• Bevacizumab
• branch retinal vein occlusion
• macular edema
• optical coherence tomography
• subretinal hemorrhage

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Author’s contributions

The first two authors (LZ and BL) contributed equally to this work. The experiment was conceived and designed by: LZ, BL, ZM and YL. The experiments were performed by: LZ, BL, and LH. The data were analyzed by: LZ, BL and KF. This paper was written by: LZ and BL.