Responce to intravitreal Bevacizumab for macular edema following central retinal vein occlusion in patients with pseudoexfoliation syndrome

Purpose To evaluate efficacy of intravitreal 1.25mg Bevacizumab in patients with pseudoexfoliation sindrome (PEX) and macular edema (ME) secondary to central or branch retinal vein occlusion. Methods A retrospective study was performed on 168 patients with central retinal vein occlusion (CRVO) and branch retinal vein obstruction (BRVO) with significant decreased visual acuity (VA) due to ME. To evaluate the role of 1.25mg bevacizumab in patients with PEX, were created two groups: the first group – 21 patients with CRVO or BRVO and clinical diagnosis of PEX (mean age 74.5 [range 63 ‐ 87]) and the second group – 21 patients with CRVO or BRVO with no clinical signs of PEX (mean age 72.7 [range 60 ‐85]). All patients were analyzed for the best corected VA and optical coherence tomography changes of the central macular thickness. Results A clinical diagnosis of PEX was present in 21 of 168 patients (12.5%), 17 (81.0%) of them had a CRVO and 4 (19.1%) – BRVO. The average of initial VA in the first group was 0.16 (SD±0.19), in the second group – 0.18 (SD±0.19). In the second group the VA after intravitreal injection of bevacizumab was significantly better (0.49 (SD±0.33)) compared to the first group (0.29 (SD±0.26)) (Mann‐Whitney test, p=0.043). Mean central retinal thickness decreased from 696.9µm (SD±261.9) to 261.0µm (SD±154.2) in the first group and 636.5µm (SD±236.9) to 254.5µm (SD±167.2) in the second group. Conclusion Pseudoexfoliation syndrome is signicantly more common in eyes with central retinal vein occlusion compared to branch retinal vein occlusion. Pseudoexfoliation syndrome could be counted as one of the factors damaging functioning of the neurosensory retina.