Intravitreal bevacizumab effective in refractory pseudophakic CME

Intravitreal bevacizumab (Avastin, Genentech) shows promise as analternative treatment modality for eyes with refractorypseudophakic cystoid macular edema (CME), according to resultsfrom an interventional, retrospective, multicenter studyconducted by the Pan-American Collaborative Retina StudyGroup.

On behalf of his co-investigators, J. Fernando Arevalo, MD,Caracas, Venezuela, presented outcomes from a series of 36 eyesof 31 consecutive patients. All of the patients had a minimumfollow-up of 12 months. All eyes had undergone uneventfulcataract surgery and had received at least one alternativetherapy before receiving intravitreal bevacizumab injection. Themean interval from diagnosis to bevacizumab injection was 10.3months. About 60% of eyes were treated with a 1.25-mg dose andthe rest with bevacizumab 2.5 mg. Recurrences were treated withanother injection, and the average eye received 2.7 injectionsover a 12-month period.

The treatment was associated with significant improvement in meanlogMAR BCVA from 0.96 at baseline to 0.62 at last exam along witha significant reduction in mean macular thickness measured by OCTfrom 500 to 286 µm.

"Follow-up is still too short to make any specific treatmentrecommendations, but the favorable results achieved through 12months suggests further study with longer follow-up in a largerseries of patients is warranted to evaluate the safety andefficacy of this new treatment modality," Dr. Arevalosaid.

"Perhaps in the future, intravitreal bevacizumab can beestablished as an alternative for treating refractory cystoidmacular edema after cataract surgery, and it may be the onlyoption in patients who are known steroid responders who areunresponsive to topical nonsteroidal anti-inflammatory drugs,"Dr. Arevalo concluded.