Loading Doses of Bevacizumab in Branch Retinal Vein Occlusion (BRVO): a Case Report


Loading Doses of Bevacizumab in Branch Retinal Vein Occlusion (BRVO): a Case Report


Andi Arus Victor

Vitreoretina Division, Department of Ophthalmology, Faculty of Medicine Universitas Indonesia Cipto Mangunkusumo National General Hospital


International-Journal-of-Case-Reports-2d code

Background: Branch retinal vein occlusion (BRVO) is a sight threatening condition which may result well when promptly diagnosed and treated. Current trend of BRVO therapy uses anti-vascular endothelial growth factor (anti-VEGF) such as bevacizumab, ranibizumab and aflibercept as agents of choice. Previous studies have proven effectiveness of six monthly injections of anti-VEGF as loading doses before switching to pro-renata regimen in BRVO. We would like to report a case with lower frequency of bevacizumab injection as anti-VEGF in a case of BRVO with satisfactory outcome. Case presentation: A 52-year old male presented with sudden painless vision loss on right eye since 2 months prior to examination. Patient had been taking medications regularly for hypertension and dyslipidemia. Patient had also been previously diagnosed with peripheral artery disease. Patient came with BCVA of 0.1 and negative pinhole on right eye while BCVA for left eye was 1.0. Relative afferent pupillary defect was positive on the right eye. Intraocular pressure and anterior segment were within normal limits for both eyes. Upon fundus examination of the right eye, findings included 0.3 CDR, dilated and tortuous retinal veins, multiple scattered preretinal hemorrhages, and macular edema. Upon posterior segment evaluation of the left eye, no abnormalities was found. Patient was then diagnosed with BRVO of the right eye and received three monthly injections of bevacizumab. Patient’s BCVA and anatomic condition improved with final BCVA of 0.5 on the right eye. Patient was monitored monthly for the next six months and there was no deterioration on the anatomical and functional outcomes.
Conclusion: Lower frequency of monthly bevacizumab injection could be beneficial in some cases of BRVO. Monthly monitoring is essential to maintain anatomical and functional outcomes.


Keywords: BRVO, bevacizumab, anti-VEGF, loading doses


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How to cite this article:
Andi Arus Victor. Loading Doses of Bevacizumab in Branch Retinal Vein Occlusion (BRVO): a Case Report. International Journal of Case Reports, 2018 3:39. DOI:10.28933/ijcr-2018-10-1201


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