Dramatic improvements seen in early CRVO with anti-VEGF therapy

Patients with central retinal vein occlusion (CRVO) who are treated early with intravitreal bevacizumab experience a dramatic improvement in visual acuity (VA) and clinical fundus appearance, without collateral vessel formation, according to a report published in the October issue of the American Journal of Ophthalmology.

D.C. Ferrara and colleagues from the Vitreous-Retina-Macula Consultants of New York, USA retrospectively evaluated five patients (six eyes) with CRVO of less than three months duration receiving intravitreal bevacizumab as primary treatment. Changes in VA, central macular thickness, venous tortuosity and diameter and optic disc oedema were recorded.

Mean baseline VA was 20/428, the mean follow-up period was 12 months and the number of bevacizumab injections ranged from four to 10. All patients demonstrated a statistically significant decrease in optic nerve head swelling, venous tortuosity and venous diameter, with the largest proportion of change occurring within one month of the first injection. Mean VA, at last follow-up, was 20/53 and no patients developed collateral vessels at the optic nerve head.

The authors believe that these dramatic improvements in VA and fundus appearance suggest that early initiation of anti-VEGF treatment should be studied in a larger trial for CRVO.