Macular ischaemia after intravitreal bevacizumab injection in patients with central retinal vein occlusion and a history of diabetes and vascular disease

Recently, there have been several reports concerning the efficacy of intravitreal bevacizumab injection (IVB) in reducing macular oedema in patients with retinal vein occlusion (RVO).1 2 According to a safety survey of IVB, adverse ocular events are extremely rare.3 At our clinic, we have performed more than 300 IVB for RVO, and the majority of these injections did not have any adverse results. However, we experienced two cases of progression of macular ischaemia despite an improvement in macular oedema after IVB for central retinal vein occlusion (CRVO) in patients with poor glycaemic control of their diabetes and a history of systemic vascular disease. ### Case 1 A 76-year-old female with diabetes for 26 years, without a history of retinopathy, presented with CRVO in the right eye (figure 1A) and no retinopathy in the left eye. She was treated with insulin, but had poor glycaemic control (HbA1c 9.6%). General blood examination revealed mild renal dysfunction (BUN: …