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OCT-Befund als Reinjektionskriterium für die 2,5-mg-Bevacizumab-Therapie bei venösen retinalen Verschlüssen

OCT-guided reinjection of 2.5 mg bevacizumab for treating macular edema due to retinal vein occlusion

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Zusammenfassung

Hintergrund

Das Makulaödem (MÖ) infolge venöser retinaler Verschlüsse lässt sich durch intravitreales Bevacizumab gut beeinflussen. Unklar ist, wann und nach welchen Kriterien Reinjektionen erfolgen sollten.

Methodik

63 Patienten (Follow-up 30±18 Wochen) wurden mit 2,5 mg Bevacizumab intravitreal behandelt. Reinjektionen erfolgten nur bei im OCT persistierendem bzw. erneut auftretendem MÖ. Nachkontrollen erfolgten alle 6–8 Wochen.

Ergebnisse

Die 1. Injektion führte bei 31 Patienten zunächst zur MÖ-Abtrocknung (Visusanstieg 3,7±3,7 Linien). Nach 13,3±4,4 Wochen kam es bei 65,2% dieser Patienten zu einem MÖ-Rezidiv, welches sich nach der 2. Injektion wieder resorbierte, wobei der Visus sich auf den Wert wie nach 1. Injektion erholte. Innerhalb von weiteren 13,4±5,4 Wochen entwickelten 69% ein weiteres MÖ-Rezidiv. Patienten mit nach 1. Injektion persistierendem MÖ (n=32) bekamen eine 2. Injektion, welche bei 33,3% zunächst zu einer MÖ-Abtrocknung, nach 13,9±4,1 Wochen aber zu einem erneuten MÖ führte.

Schlussfolgerung

Das OCT-gesteuerte Reinjektionsprozedere bei der Bevacizumab-Therapie venöser Verschlüsse führt trotz vorübergehender MÖ-Rezidiventwicklung zur anatomischen und funktionellen Befundstabilisierung bzw. -besserung.

Abstract

Background

Macular edema (ME) due to retinal vein occlusion can be successfully treated with intravitreal bevacizumab therapy. There is no common recommendation concerning time intervals and criteria for reinjection.

Method

Sixty-three patients (follow-up 30±18 weeks) received intravitreal injections of 2.5 mg bevacizumab. Reinjection was performed only if optical coherence tomography (OCT) showed persistent or recurrent ME. Check-ups were performed every 6–8 weeks.

Results

There was complete resolution of macular edema in 31 patients after the first injection (improvement in visual acuity 3.7±3.7 lines); 65.2% of these patients developed recurrence of ME within 13.3±4.4 weeks, which completely resolved again after a second injection. Visual acuity gained the same level as after the first injection. Another relapse of ME in this group occurred in 69% of patients after another 13.4±5.4 weeks. Patients with persistent ME after the first injection (n=32) received a second injection, initially leading to resolution of ME in 33.3%, but all of these patients had a relapse within 13.9±4.1 weeks.

Conclusion

OCT-guided reinjection leads to anatomic and functional stabilization or improvement even if transient recurrence of ME occurs.

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Authors and Affiliations

  1. Schwerpunkt Retinologie, Universitäts-Augenklinik, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    A.E. Höh, K.B. Schaal, A. Scheuerle, F. Schütt &  S. Dithmar

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  1. A.E. Höh
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  2. K.B. Schaal
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  3. A. Scheuerle
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  4. F. Schütt
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  5. S. Dithmar
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Corresponding author

Correspondence to S. Dithmar.

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Unterstützt von der Gertrud Kusen Foundation (Di 2007/2008)

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Höh, A., Schaal, K., Scheuerle, A. et al. OCT-Befund als Reinjektionskriterium für die 2,5-mg-Bevacizumab-Therapie bei venösen retinalen Verschlüssen. Ophthalmologe 105, 1121–1126 (2008). https://doi.org/10.1007/s00347-008-1759-2

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  • DOI: https://doi.org/10.1007/s00347-008-1759-2

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