Intravitreal Bevacizumab for Refractory Pseudophakic Cystoid Macular Edema. The Pan-American Collaborative Retina Study Group Results

Objective: To determine the feasibility, safety, and clinical effect of intravitreal (IVT) bevacizumab (Avastin; Genentech, Inc., San Francisco, CA) in patients with refractory cystoid macular edema (CME) after cataract surgery. Design: Interventional, retrospective, multicenter study. Participants: Thirty-six eyes of 31 patients with refractory CME after cataract surgery and with a mean age of 68.2 years (range, 67-87 years). Methods: Patients were treated with at least 1 IVT injection of 1.25 or 2.5 mg bevacizumab. Patients were followed up for 12 months. Main Outcome Measures: Best-corrected visual acuity (BCVA) and central macular thickness (CMT) by optical coherence tomography (OCT). Results: Twenty-six eyes (72.2%) demonstrated improvement of BCVA (≥2 Early Treatment Diabetic Retinopathy Study [ETDRS] lines), and no eye experienced worsening of visual acuity (≥2 ETDRS lines). Mean baseline BCVA was 20/200 (0.96 logarithm of the minimum angle of resolution [logMAR] units), and the mean 12-month BCVA was 20/80 (0.62 logMAR units; P<0.0001). Optical coherence tomography demonstrated that mean CMT at baseline was 499.9 μm (range, 298-784 μm) and decreased to a mean of 286.1 μm (range, 168-499 μm) at 12 months (P<0.0001). Four (11%) eyes received 2 injections, 10 (27.8%) eyes received 3 injections, 10 (27.8%) eyes received 4 injections, 1 (2.8%) eye received 5 injections, and 1 (2.8%) eye received 6 injections. The mean number of injections was 2.7 (range, 1-6), and the mean interval between injections was 15.1 weeks (range, 4-45 weeks). No ocular or systemic adverse events were observed. Conclusions: Short-term results suggest that IVT bevacizumab is well tolerated in patients with refractory pseudophakic CME. Treated eyes had a significant improvement in BCVA and decrease in macular thickness by OCT at 12 months. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.