Angiographically Documented Macular Ischemia after Single Bevacizumab for Macular Edema Secondary to Central Retinal Vein Occlusion.

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MeSH: Aged ; Angiogenesis Inhibitors/administration & dosage* ; Antibodies, Monoclonal/therapeutic use ; Antibodies, Monoclonal, Humanized/therapeutic use ; Bevacizumab/administration & dosage* ; Bevacizumab/adverse effects ; Female ; Fluorescein Angiography ; Humans ; Intravitreal Injections ; Macular Edema/diagnosis ; Macular Edema/drug therapy* ; Macular Edema/etiology ; Male ; Middle Aged ; Retina/drug effects* ; Retina/pathology ; Retina/physiopathology ; Retinal Vein Occlusion/complications* ; Retinal Vein Occlusion/diagnosis ; Retinal Vein Occlusion/drug therapy* ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Endothelial Growth Factor A/immunology ; Visual Acuity/physiology ; Vitreous Body

Keywords: Macular edema ; bevacizumab ; central retinal vein ; fluorescein angiography ; fovea centralis

Abstract: This report describes a case of angiographically documented foveal avascular zone (FAZ) enlargement after a single intravitreal injection of bevacizumab for macular edema secondary to central retinal vein occlusion (CRVO). A 71-year-old female was treated with an intravitreal bevacizumab injection for macular edema following CRVO. Despite successfully decreased edema one month after injection, the postinjection best-corrected visual acuity immediately decreased from 20/40 to 20/1000 (Snellen equivalent). The FAZ area increased from 0.37 mm² to 3.11 mm² (8.4-fold increase). While intravitreal anti-vascular endothelial growth factor is effective and should be considered as a first-line treatment for macular edema secondary to CRVO, it may aggravate macular ischemia.