Bevacizumab is frequently used off-label for treating macular oedema resulting from central retinal vein occlusion (CRVO), despite a lack of supporting data.
In a study published in JAMA
(online, 9 May 2017), researchers carried out a randomised trial to establish whether the drug is non-inferior to aflibercept, a licensed treatment for CRVO with a similar mode of action. After six months of injections every four weeks, the mean change in visual acuity letter score increased by 18.6 in the bevacizumab group (n=182) and by 18.9 in the aflibercept group (n=180), a difference between the two groups that met the criteria for non-inferiority.
The researchers say the results demonstrate the efficacy of this class of drugs for treating macular oedema secondary to CRVO, but long-term follow up is needed to assess the treatment needs of this group of patients over time.
 Scott I, VanVeldhuisen P, Ip M et al. Effect of bevacizumab vs aflibercept on visual acuity among patients with macular edema due to central retinal vein occlusion. JAMA 2017. doi: 10.1001/jama.2017.4568