Sanaullah Jan, Muhammad Naeem Khan, Samina Karim, Muhammad Tariq Khan, Zakir Hussain, Sadiqullah Khan, Muhammad Nazim.
Anti vascular endothelial growth factor (bevacizumab) in central retinal vein occlusion: an interventional case series.
Pak J Med Res Jan ;49(2):39-43.

Background: Vascular endothelial growth factor plays major role in ocular angiogenesis and retinal edema production and is a step forward in the management of ocular neovascularization and retinal edematous pathologies. Objectives: To determine the efficacy and safety of intra-vitreal Avastin (Bevacizumab) in cases having central retinal vein occlusion. Study design: A prospective interventional study. Place and duration: This study was done at Said Anwar Medical Centre, Dabgari Gardens, Peshawar from June, 2007 to September, 2009. Patients and Methods: All patients with central retinal occlusion occurring in the past 3 months and seen between the study period were included in the study. Diagnosis of central retinal vein occlusion was made clinically by slit lamp biomicroscopy with 78D examination Patients who had received any treatment for and eyes which already had developed Anterior Segment Neovascularization, Neovascularization elsewhere or Neovascularization on disc at presentation were excluded. Dose of 0.05 ml (1.25mg) of Avastin (Bevacizumab) was used as intra vitreal injection every month for 3 months in cases that presented within a month of occlusion and less injections were given in dose presenting later. Follow-up was done at 30th, 60th, 90th and 120th day after the onset of disease. Visual outcome was defined as Snellen’s or LogMar Best Corrected Visual Acuity at final follow up, of 120th day, compared to the visual acuity at presentation. Data were analyzed by SPSS version 17. Results: Total of 17 eyes of 17 patients were included in this study. Eleven (64.7%) patients were males while 6(35.3%) were females. Total of 40 intra-vitreal injections of Avastin were given to patients with a mean of 2.35 injections per eye. Good visual outcome was achieved in 10(58.8%) eyes, while 7(41.2%) had stable visual outcome. Mean initial Best Corrected Visual Acuity (LogMar) in all 17 eyes was 1.79(SD+0.87) which significantly improved to a mean of 1.18 (SD+0.77) at final follow up. Mean improvement in Best Corrected Visual Acuity (LogMar) after paired sample test in all patients at final follow up on day 120 was 0.61(SD+0.84). Retinal hemorrhages and macular edema decreased clinically on examination on consecutive follow up visits. No eye developed neovascularization elsewhere, neovascularization on the disc, neovascularization, retinal tears, retinal detachment, lens trauma, endophthalmitis or anterior chamber activity. Conclusions: Bevacizumab (Avastin) is an effective and safe treatment option for central retinal vein occlusion affected eyes and resulted in improvement in visual acuity. It reduced macular edema and prevented ocular neovascularization at least for short term.

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