Abstract
Purpose: :
To evaluate the macular characteristics of patients who require increased injection frequency with bevacizumab for diabetic macular oedema (DMO).
Methods: :
A post-hoc analyses of the patients randomised to the bevacizumab arm of a prospective, randomized controlled trial (BOLT study) was done to assess the factors that determine the need for more frequent injections in patients with DMO. The injection frequency was divided into 6 or less injections versus more than 6 injections in the first 12 months. In the following 12 months, the injection frequency was divided into 3 or less injections versus more than 3 injections. The baseline and month 12 OCT scans were assessed for the presence of diffuse intraretinal fluid, cystoid oedema and subretinal fluid. Other baseline data evaluated included age, gender, visual acuity, macular thickness, macular volume, duration of diabetes, HbA1C and diameter of foveal avascular zone. Univariate analyses followed by multivariate logistic regression was done using STATA.
Results: :
A total of 37 eyes were evaluated in the study. All patients with serous retinal detachment required higher frequency of injections in both the first and second year of therapy (n=9). However, it did not reach statistical significance. None of the other factors determined injection frequency at 12 months. However, at 24 months patients with lower visual acuity (p=0.03) and thicker central macula (p=0.04) at 12 months required more injections after adjusting for other study factors.
Conclusions: :
This study results suggest that morphological characteristics of the macula in DMO may determine the frequency of injections.However, further studies with larger sample sizes are required to confirm these findings.
Clinical Trial: :
https://eudract.ema.europa.eu 2007-000847-89
Keywords: diabetic retinopathy • imaging/image analysis: clinical • retina