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After injection

Efficacy of Vitreous Injection of Bevacizumab of Pseudophakic CME. Before injection. Yoshihide Nakai, Kyoko Bessyo Yuko Shono, Yoshimasa Nakai Tsu:Japan. After injection. Financial Interest Disclosure : None. Purpose. If left untreated, CME after cataract

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After injection

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  1. Efficacy of Vitreous Injection of Bevacizumab of Pseudophakic CME Beforeinjection Yoshihide Nakai, Kyoko Bessyo Yuko Shono, Yoshimasa Nakai Tsu:Japan Afterinjection Financial Interest Disclosure : None

  2. Purpose If left untreated, CME after cataract surgery may leave permanent visual inpairment. The efficacy of vitreous injection of bevacizumab for this disease was investigated.

  3. Method 12 patients with CME after cataract surgery that did not respondto nonsteroid anti-inflammatory drugs (NSAIDs) were administered. Bevacizumab 1.25mg as vitreous injection between 6 and 12weeks after surgery. The thickness of the macula (OCT,cirrus) and the visual acuity were examined before and after injection (1week, 1 and 3months).

  4. Bevacizumab 1.25mg vitreous injection The surgical procedure shows the way of which bevacizumab is injected into a vitreous. I performed a surgery after sterilization and ocular anesthesia. It’s injected into a vitreous using 30G needle.The bevacizumab injected was 1.25mg.After vitreous injection, the occular pressure was checked and ended the procedure.

  5. Bevacizumab 1.25mg vitreous injection 12patients(6~12weeks after surgery) CME after cataract surgery that did not respond NSAIDs

  6. Results The mean BCVA was 20/60(20/100-20/35) before injection of bevacizumab, and it improved to 20/30(20/70-20/20) at 1week, 20/25(20/50-20/20) at 1month, and 20/20 at 3months after injection. The thickness of the macula improved from a mean pre-injection value of 765μm (511-892μm) to 590μm (391-685μm) at 1week,371μm(287-509μm) at 1month, and 225μm (190-310μm) at 3months after injection

  7. The visual acuity, before and after injection 20 40 20 20 20 40 20 30 20 25 20 20 BCVA 1week after injection 1 month after injection 3 month after injection before Bevacizumab injection

  8. Macula Thickness, before and after injection 800 μm 765 μm 590 μm 500 μm 371 μm 200 μm 225 μm 1week after injection 1 month after injection 3 month after injection before Bevacizumab injection Macula Thickness

  9. Discussion Cystoid macular edema (CME) occur after phacoemulsification and IOL insertion surgery. When a FA check was done, its frequency was 70%.It’s healing is almost naturally, but with 2% visual acuity cut-down. If CME continues for several months, the change in macula becomes irreversible and visual acuity cut down continues. There are steroid and nonsteroidal antiinflammatory agents (NSAIDs) treatment, but there are ineffectiveness case for both.

  10. Discussion-continued There is an action which restrains vascular endothelial growth factor (VEGF) but bevacizumab when used it also has the effect which restrains vasopermeability. An inflammation forms after surgery, and blood retinal barrier (BRB) fails because of it, and vasopermeability of macula increases, and CME forms. I think bevacizumab restrained this vasopermiability and made CME to be healed.

  11. Conclusion In cases of CME after cataract surgery that do not respond to steroid and NSAIDs, vitreous injection of bevacizumab is an effective therapy to improve visual acuity.

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