25. Development of collateral vessels under Avastin® –
Therapy for branch retinal vein occlusion
Jörg Christian Schmidt (Marburg)
Background: Avastin® is being used increasingly in treatment of macular diseases of various
origin. Since these disease have different pathogeneses, effect of Avastin® has to be questioned.
It remains to be examined, whether Avastin® inhibits any type of neovascularisation or whether
it has a selectiv effect on certain vessels and thus reduces edema.
Material and methods: We present a 46year-old patient, who developed collateral vessels following
four Avastin® injections after undergoing vitrectomy with ILM-peeling and sheathotomy
for an ischemic branch retinal vein occlusion.
Biomicroscopic findings, fluorescence angiography, visual acuity and OCT-findings are compared
and followed up.
Results: Five weeks after vitrectomy with ILM-peeling and sheathotomy, a first Avastin® injection was performed in a 46year old
patient suffering from a branch retinal vein occlusion leading to an increase in visual acuity from 0.4 to 0.9.
This treatment was repeated three times because of visual loss and retinal edema. One to two weeks after each injection,
visual acuity increased and retinal thickness decreased.
Anastomoses were first found about 8 weeks after vitrectomy. Their number increased while ischemic areas decreased simultaneously.
Conclusion: Since Avastin® inhibits vascular endothelial growth factor, one would expect that no collateral vessels or anastomoses
develop.
On the contrary, we observed new vessel devolpement despite that treatment in our patient. Collateral vessel development
may be different in different disease entities. This could help in the understanding of the effect of Avastin® treatment for
retinal vein occlusion.