Charlotte Hvarfner

Clinical and electrophysiologic outcome in patients with neovascular glaucoma treated with and without bevacizumab.

Purpose To investigate the clinical and electrophysiologic effect of a single intravitreal injection of bevacizumab for neovascular glaucoma (NVG) after ischemic central retinal vein occlusion (iCRVO). Methods Nineteen eyes from 19 patients with NVG secondary to iCRVO were randomly allocated to either an intravitreal bevacizumab injection and panretinal photocoagulation (PRP) (10 eyes) or PRP alone (9 eyes). The primary outcome measure was the change in the total retinal function 6 months after treatment, demonstrated by full-field electroretinography (ERG). Secondary outcomes included visual acuity, intraocular pressure (IOP), glaucoma medication, additional IOP-lowering treatment, and the presence of ocular neovascularization before treatment, and 1 week, 2 months, and 6 months after treatment. Results The regression of ocular neovascularization in the bevacizumab/PRP group was confirmed 1 week after injection. Patients in both study groups had very poor visual acuity at baseline. This remained unchanged. There was no significant difference in the mean IOP between the groups at any point in time. The a-wave amplitudes of combined rod-cone response were significantly decreased after 6 months in the bevacizumab/PRP group (p=0.028), compared with the baseline values. The a- and b-wave amplitudes of combined rod-cone response and the b-wave amplitudes of the 30-Hz flicker response were also markedly reduced compared with the PRP group (–60%, −43%, −47% vs +23%, −36%, −16%, respectively). Conclusions This study suggests that intravitreal injection of bevacizumab is valuable in the treatment of NVG by hastening the resolution of neovascularization, while the full-field ERG results indicate that bevacizumab may reduce the photoreceptor function in NVG patients.

Multifocal electroretinogram in branch retinal vein occlusion

PURPOSE To describe the response from multifocal electroretinography in branch retinal vein occlusion. DESIGN Prospective observational case control series. METHODS Multifocal electroretinography was recorded in 15 patients with temporal branch retinal vein occlusion and 21 control subjects using a visual evoked response imaging system. RESULTS There were significant differences in mean amplitude (P =.01) and latency (P =.001) between thrombotic and nonthrombotic retina in the same eyes, as well as in patients compared with control subjects. CONCLUSION Responses from multifocal electroretinography demonstrate retinal dysfunction in branch retinal vein occlusion; additional studies will demonstrate whether multifocal electroretinography has a prognostic value.

Is optic nerve head swelling of prognostic value in central retinal vein occlusion

PurposeTo investigate the prognostic value of optic nerve head swelling (ONHS) in central retinal vein occlusion (CRVO) and compare it to other prognostic factors.MethodsSeventy-four patients with CRVO were studied retrospectively. The parameters analysed were the initial presence of ONHS, the fluorescein angiographic appearance, the implicit time in the 30-Hz flicker ERG and the initial visual acuity. The aspects of outcome studied were the development of neovascular complications and the visual acuity 1 year after the thrombotic event.ResultsFluorescein angiography, ERG and initial visual acuity were of prognostic value in CRVO, whereas ONHS was of questionable value.ConclusionONHS is most likely of no prognostic value in CRVO.