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Yoshihiro Takamura, Takeshi Tomomatsu, Takehiro Matsumura, Yuji Takihara, Masaru Inatani; Photocoagulation for peripheral nonperfusion-areas to prevent the recurrence of diabetic macular edema after single intravitreal injection of bevacizumab. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2377.
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© ARVO (1962-2015); The Authors (2016-present)
Although intravitreal injection of bevacizumab (IVB) is strong tool to treat diabetic macular edema (DME), multiple injections are necessary to maintain its therapeutic effect. Randomized prospective study was carried out to investigate whether the photocoagulation (PC) for peripheral ischemic area has effect to prevent the recurrence of DME after IVB.
Patients with DME were randomized to receive 1.25mg IVB (IVB group) and IVB with combination of peripheral PC for ischemic retina determined by fluorescein angiography (IVB+PC group). At 2 weeks before IVB, grid/focal PC was performed in both groups. Every month after IVB up to 6 months, best corrected visual acuity (BCVA) and central retinal thickness (CRT) determined by optical coherence tomography were measured.
Forty-one eyes of 41 patients (68.8±4.6 years) were participated and eyes were randomized to IVB group (n=20) and IVB+PC group (n=21). At the treatment of grid/focal PC and IVB, there was no significant difference in BCVA and CRT between the groups. At 1 month after IVB, both groups exhibited significant decrease in CRT. Decreased CRT in IBV+PC group was maintained thereafter, while CRT in IVB group turned to increase. The average of CRT in IVB+PC group was significantly smaller than that of IVB group at 3 months and thereafter (p<0.05; unpaired Student’s t-test). Significant improvement of BCVA was not observed in IBV group, whereas IVB +PC group showed significant improvement at 4 months (p<0.05; paired Student’s t-test), and significant difference between groups was noticed at 4 and 5 months (p<0.05; unpaired Student’s t-test).
The combination of photocoagulation for peripheral nonperfusion-area with grid/focal PC and IVB treatments provided benefit for patients with DME to prevent the recurrence of residual edema.
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