Intravitreal bevacizumab effective for uveitic cystoid macular oedema

A recent study has demonstrated that intravitreal bevacizumab (IVB) is safe and efficient for the treatment of uveitic cystoid macular oedema compared with triamcinolone acetonide. The results of this study have been published in Retina.

The study, led by Dr Jeong Hun Bae of the Institute of Vision Research and Department of Ophthalmology, Yonsei University College of Medicine, Korea, involved 31 eyes of 31 patients with persistent uveitic cystoid macular oedema. Ten eyes were administered with 40 mg of posterior sub-Tenon triamcinolone acetonide (PSTA), 11 eyes were injected with 4 mg of intravitreal triamcinolone acetonide (IVTA) and 10 eyes received 1.25 mg of IVB. Optical coherence tomography was used to measure central foveal thickness and differences in visual acuity with a logarithmic minimal angle of resolution were analysed.

There was a mean follow-up period of 22.3 weeks and within this period the best improved visual acuity and reduction in central foveal thickness for all groups was observed at week 4.

However, these worsened with time until week 12. The researchers found that IVTA gave better results than those found with IVB or PSTA but the difference was not considered to be statistically significant. It was also shown that IVB gave significantly better results in visual acuity gain for eyes with Behcet uveitis when compared to those eyes with non-Behcet uveitis. Additionally, the median period of effect was 16 weeks for IVB, 30 weeks for IVTA and 12 weeks for PSTA according to Kaplan-Meier survival analysis.

It was concluded that IVB was well-tolerated by the study group and was an effective additional therapy for persistent uveitic cystoid macular oedema, namely in Behcet uveitis patients at risk of increased IOP. However, the study revealed the issue of limited efficacy of IVB, which means reinjection may be required to maintain the positive effects of IVB.