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. 2022 Jun 11;8(1):37.
doi: 10.1186/s40942-022-00389-x.

Combined intravitreal injection of bevacizumab and a ROCK inhibitor (fasudil) for refractory macular edema secondary to retinal vein occlusion: a pilot study

Sahba Fekri  1   2 , Ramin Nourinia  3   4 , Babak Rahimi-Ardabili  1 , Arash Daneshtalab  1 , Hamideh Sabbaghi  5   6 , Hamid Ahmadieh  1 , Bahareh Kheiri  1
Affiliations

Combined intravitreal injection of bevacizumab and a ROCK inhibitor (fasudil) for refractory macular edema secondary to retinal vein occlusion: a pilot study

Sahba Fekri et al. Int J Retina Vitreous. .

Abstract

Background: To investigate the adjunctive effect of an intravitreal ROCK inhibitor (fasudil) in combination with intravitreal bevacizumab (IVB) on refractory macular edema secondary to retinal vein occlusion (RVO).

Methods: In this prospective interventional case series, 17 eyes of 17 patients (10 men, 7 women) with refractory RVO-related macular edema underwent three consecutive intravitreal injections of bevacizumab plus fasudil. Monthly evaluation was continued up to 12 months and IVB injection was performed if needed during the follow-up. Changes in the best corrected visual acuity (BCVA) was the primary outcome measure. The secondary outcome measures included central macular thickness (CMT) changes and any adverse events.

Results: BCVA significantly improved (mean change: -0.15 LogMAR; P = 0.017) after 3 consecutive intravitreal injections of fasudil in combination with bevacizumab. CMT significantly decreased (mean change: -206 µm; P = 0.028). The anatomical and functional improvement was maintained during the 12 month follow-up. No adverse effects were noticed.

Conclusion: Intravitreal ROCK inhibitors may break the resistance to anti-VEGF therapy and improve the RVO induced macular edema via affecting the VEGF-independent pathways.

Keywords: Bevacizumab; Fasudil; Macular edema; ROCK inhibitor; Retinal vein occlusion.

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Conflict of interest statement

The authors declare that they have no competing interests.

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