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P. A. Salvetti, L. Bonavia, C. Rosina, P. Sabella, M. Draghi, G. Staurenghi; Intravitreal Bevacizumab in the Treatment of Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4250.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy of 3 consecutive intravitreal bevacizumab injections (IVB) in the treatment of Diabetic Macular Edema (DME)
Prospective consecutive non comparative series of 17 eyes of 17 patients (5 females) with DME, considered not responding to laser photocoagulation, treated with 3 bevacizumab injections (1.25 mg) at regular intervals of 6 weeks; mean age was 65 years (range 55-84).Inclusion criteria are: 1) best correct visual acuity (BCVA) ranging from 0.625 to 0.1; 2) optical coherent tomography (OCT) central subfield thickness equal or more than 300 microns.Exclusion criteria are: 1) treatment of DME in the previous 6 months, 2) OCT findings of vitreomacular traction, 3) pathological enlargement of the foveolar avascular zone at fluorescein angiography 4) cataract surgery in the previous 12 months.Visual acuity (VA) and OCT was performed at baseline and before every IVB, than montly until the end of the FU.
In 9 patients VA improved (5 or more ETDRS letters) after the 1st IVB and the improvement persisted for 4-5 w after the 3rd IVB.In 4 patients the VA was stable after the 1st IVB and improved only after the 2nd IVB persisting 4-5 w after the 3rd IVB. In 4 patients we had any improvement of VA after three IVB.In the group of 13 patient with improvement after the complete treatment 9 patients had persistent improvement at 3 months FU after the last IVB, but only in 4 patients the improvement persisted at 4 months FU. These 4 patients have shown a persistent VA at 6 months after the 3rd IVB.At baseline mean BCVA of the 17 patients was 0.32 (range 0.16 - 0.625); 4-5 w after the 1st IVB was 0.43 ; 4-15 w after the 2nd IVB was 0.47 ; 4-5 w after the 3rd IVB was 0.44 ; 12-13 w after the 3rd IVB was 0.42.At baseline mean OCT-CMT of the 17 patients was 515 (range 348-623); 4-5 w after 1st IVB was 375; 4-5 w after 2nd IVB was 376; 4-5 w after 3rd IVB was 372; 12-13 w after the 3rd IVB was 410.
our case history of 3 consecutives IVB in DME is associated with an improvement in VA in 13 out of 17 patients, but at 6 months after the 3rd IVB the visual improvement persisted only in 4 patients. Further clinical trials are needed to evaluate a larger number of patients and to identify the DME types that are more responsive to bevacizumab IVB.
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