Macular ischemia may predict visual outcomes in patients with macular edema due to BRVO

The preoperative presence of macular ischemia can be a useful predictor of visual acuity after using intravitreal bevacizumab to treat patients with macular edema due to branch retinal vein occlusion, a retrospective study suggests.

In order to determine prognostic factors for visual outcomes, Eun Jee Chung, MD, and colleagues reviewed 50 eyes of 50 patients who were administered intravitreal Avastin (bevacizumab, Genentech) for macular edema secondary to BRVO.

Subsequently, the investigators divided all patients into two groups based on final visual acuity. Group one consisted of 28 eyes (56%) that had gained five or more ETDRS letters over a minimum of 3 months' follow-up; group two consisted of 22 eyes (44%) that had either gained less than five letters or had worsened at final follow-up. Clinical and fluorescein angiographic differences were then compared between the two groups.

The investigators found that significantly more eyes in group one showed visual improvement 1 month after initial bevacizumab injection (P < .001).

"The early gainers who favorably responded to the initial intravitreal bevacizumab injection are most likely to benefit from the bevacizumab treatment," the authors said.

The investigators also found that more eyes in group two had angiographically documented macular ischemia (P < .001). In these eyes, a decrease in central macular thickness did not correlate with improved visual acuity, according to the study, published in the September issue of Graefe's Archive for Clinical and Experimental Ophthalmology.