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J. Arevalo, J. G. Sanchez, L. Wu, M. Maia, A. A. Alezzandrini, M. Brito, S. Bonafonte, M. Diaz-Llopis, N. Restrepo, The Pan-American Collaborative Retina Study Group(PACORES); Comparison of 2 Doses of Primary Intravitreal Bevacizumab for Diffuse Diabetic Macular Edema: Results From the Pan-American Collaborative Retina Study Group at 24 Months. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1680.
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To report the 24-month anatomic and ETDRS best-corrected visual acuity (BCVA) response after primary intravitreal bevacizumab (Avastin®) (1.25 mg or 2.5 mg) in patients with diffuse diabetic macular edema (DDME). In addition, a comparison of the 2 different doses of intravitreal bevacizumab (IVB) utilized was made.
We reviewed the clinical records of 115 consecutive patients (139 eyes) with DDME in this interventional retrospective multicenter study at 11 centers from 8 countries. All patients with a follow-up of 24 months were included in this analysis. Patients underwent ETDRS best-corrected visual acuity (BCVA) testing, ophthalmoscopic examination, optical coherence tomography (OCT), and fluorescein angiography (FA) at baseline and follow-up visits.
The mean age of our patients was 59.4 ± 11.1 years. The mean number of IVB injections per eye was 5.8 (range: 1 to 15 injections). In the 1.25 mg group at 1 month BCVA improved from 20/150, logMAR 0.88 to 20/107, logMAR 0.76 (P < 0.0001). This improvement was maintained throughout the 3-, 6-, 12-, and 24-month follow-up. The mean final BCVA at 24 months was 20/75, logMAR = 0.57 (p < 0.0001). Similar BCVA changes were observed in the 2.5 mg group. In the 1.25 mg group, the mean central macular thickness (CMT) decreased from 466.5 ± 145.2 µm at baseline to 332.2 ± 129.6 µm at 1 month, 358.8 ± 111.8 µm at 3 months, 317.6 ± 87.7 µm at 6 months, 299.1 ± 79.4 µm at 12 months, and 286.6 ± 81.5 µm at 24 months (p<0.0001). Similar CMT results were seen in the 2.5 mg group. Adverse events included transient high blood pressure in 1 (0.9%) patient, cerebrovascular accident in 1 (0.9%) patient, heart attack in 1 (0.9%) patient, and transient increased intraocular pressure in 7 (5%) eyes.
Primary IVB at doses of 1.25 to 2.5 mg seem to provide stability or improvement in BCVA, OCT, and FA in DDME at 24 months. There seems to be no difference on our results between IVB at doses of 1.25 mg or 2.5 mg.
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