Comment of article by Matsumoto Y

Dear Editor: We read with interest the article by Matsumoto et al 1 in a recent issue of Retina. They described three patients with macular edema secondary to retinal vein occlusion who had initial resolution of edema after bevacizumab injection followed by rebound edema. Matsumoto et al hypothesized that blockage of the vascular endothelial growth factor (VEGF) pathway by bevacizumab may inhibit and/or stimulate some molecular processes in the VEGF cascade, resulting in increased edema. In support of this hypothesis, we describe a 74-year-old woman who was diagnosed with branch retinal vein occlusion in the right eye and treated with bevacizumab. It would be of interest to perform molecular studies on ocular fluids from patients undergoing antiangiogenic treatments in an attempt to better identify the phenomenon. Unfortunately, difficulty in accessing the ocular cavities and concerns about the ethicality of this surgical procedure make this task scarcely feasible at this point.