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Recurrence of macular edema may be associated with early initiation of anti-VEGF treatment
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A study suggested that reappearance of macular edema in patients with branch retinal vein occlusion may be more probable when bevacizumab therapy begins before the edema has reached its peak.
The retrospective review analyzed 65 eyes of 65 patients who received a single 1.25 mg dose of Avastin (bevacizumab, Genentech) and were followed up monthly for at least 6 months. A second dose was administered upon recurrence, which was defined as a 110% or greater increase in foveal thickness.
Seven eyes (10.8%) experienced reappearance of macular edema, and a thinner pretreatment fovea and shorter interval between symptom onset to initiation of treatment were significantly associated with this rebound (P < .01). For all eyes with recurrence, treatment began less than 8 weeks after symptom onset.
There were no significant differences between post-therapy outcomes for eyes with or without rebound, suggesting that poorer visual acuity may not be a consequence. The study authors postulated that a shorter follow-up interval might lead to earlier detection and treatment, potentially lowering the incidence of recurrence.