Acetazolamide and Bevacizumab Combination Therapy Versus Bevacizumab Monotherapy in Macular Edema Secondary to Retinal Vein Occlusion; [Traitement Combine Par Acetazolamide Et Bevacizumab Par Rapport a La Monotherapie Par Bevacizumab Dans L’Oedeme Maculaire Secondaire a Une Occlusion Veineuse Retinienne] Publisher Pubmed



Karimi S^{1, 2, 3} ; Nikkhah H^{1, 2, 3} ; Nafisi H^{1, 3} ; Nouri H^{1, 4} ; Ansari I^{1, 3} ; Barkhordari S^{1, 3} ; Samnejad S^{1, 3} ; Abtahi SH^{1, 2, 3} Show Affiliations
Source: Journal Francais d'Ophtalmologie Published:2023

Abstract

Purpose: To determine and compare the efficacy of intravitreal bevacizumab (IVB) and oral acetazolamide (OA) combination therapy versus IVB monotherapy in patients with macular edema secondary to retinal vein occlusion (RVO). Methods: This randomized clinical trial included 54 eyes of 52 patients with RVO central macular thickness (CMT) of more than 300 μm, and best corrected visual acuity (BCVA) between 20/400 and 20/40. Eligible patients were randomly assigned to two groups: (I) IVB and OA (250 mg twice daily) combination therapy or (II) IVB monotherapy. Ocular injections were repeated monthly for up to three months; BCVA and CMT were measured monthly. Results: Both regimens resulted in significant reduction in CMT (534 ± 150 μm to 352 ± 90 μm in the IVB + OA group, P < 0.001; and 580 ± 175 μm to 362 ± 90 μm in the IVB group, P < 0.001); neither showed superiority in this regard. Likewise, BCVA showed significant improvement in both groups (0.87 ± 0.56 to 0.53 ± 0.28 LogMAR in the IVB + OA group, P = 0.001; and 0.85 ± 0.62 to 0.46 ± 0.4 LogMAR in the IVB group, P < 0.001), with no intergroup difference. Conclusion: Addition of oral acetazolamide to IVB in eyes with macular edema secondary to RVO may not result in additional short-term benefits regarding functional and anatomical outcomes. Trial registration: ClinicalTrials.gov, NCT05290948, registered on March 22, 2022. https://clinicaltrials.gov/ct2/show/NCT05290948 © 2023 Elsevier Masson SAS