Posterior Sub-Tenon’s Capsule Injection of Bevacizumab for Treatment of Diffuse Diabetic Macular Edema

Abstract

Purpose: : To evaluate the effect of posterior sub-tenon’s injection of bevacizumab for treatment of diffuse diabetic macular edema.

Methods: : Prospective, longitudinal, interventional and non-comparative pilot study.Seven consecutive patients (7 eyes) with non proliferative diabetic retinopathy and diffuse macular edema were treated with a single posterior sub-tenon’s capsule injection of bevacizumab (2.5 mg /0.1ml Avastin® Genentech, San Francisco, California). Evaluation included best corrected visual acuity (BCVA), intraocular pressure, fundus examination, systemic blood pressure and foveal thickness by optical coherence tomography (OCT) at the initial examination and 3, 6 and 12 weeks after treatment.

Results: : Baseline foveal thickness was 386.42±117.96 µm. At 3 weeks after treatment it decreased to 307±48.74 µm (p=0.11). At 6 and 12 after treatment the foveal thickness was 322.6±90.09 µm (p=0.22) and 336.6±80.25 µm (p=0.25) respectively. Average macular volume at baseline was 10.59±2.26µm. At 3, 6 and 12 weeks after treatment was 10.17±1.79 µm (p=0.94), 10.49±2.02 µm (p=1), 10.16±1.92 µm (p=0.52) respectively. BCVA decreased in 5 patients (71.42%) and increased in 2 patients (28.57%). There was no significant difference in systemic and intraocular pressure. No adverse effects or complications were observed.

Conclusions: : Posterior sub-tenon’s injection of bevacizumab decreased diffuse diabetic macular edema, although we did not find statistically significant differences. A long term follow-up in a larger series of patients is necessary in order to conclude if this modality of treatment is effective.

Clinical Trial: : www.clinicaltrials.gov NCT00567372

Keywords: diabetic retinopathy • diabetes • edema