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M. J. Saravia, A. Alezzandrini, M. H. Berrocal, J. Arevalo, L. Wu, C. Marini, M. Garcia; Comparison of Primary Intravitreal Bevacizumab vs. Grid Laser Photocoagulation for Difuse Diabetic Macular Edema: Results From the Pan-American Collaborative Retina Study Group at 24-Months. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4255.
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To compare the anatomic and functional outcomes at 24 months of eyes with diffuse diabetic macular edema (DDME) treated with primary intravitreal bevacizumab (Avastin) or grid macular photocoagulation (GMP).
Retrospective, multicenter, comparative, interventional study of 98 patients (98 eyes) treated with grid macular photocoagulation (Laser Group) and 115 patients (139 eyes) treated with intravitreal bevacizumab (IVB) at doses of 1.25 mg or 2.5 mg per injection (IVB Group) with a follow-up of 24 months. Patients underwent Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA) testing, ophthalmoscopic examination, optical coherence tomography (OCT), and fluorescein angiography (FA) at baseline, 1-, 3-, 6-, 12- and 24-month visits. Main outcome measures were changes in BCVA and OCT. Re-treatments were determined according to OCT results.
In the IVB Group, the BCVA at 24 months improved from logMAR 0.88 (20/150) to logMAR 0.57 (20/75) (p<0.0001) . The mean central macular thickness (CMT) decreased from 466.5 ± 145.2 µm at baseline to 286.6 ± 81.5 µm at 24 months (p<0.0001) . In the Laser Group, BCVA at 24 months improved from logMAR 0.8 (20/125) to logMAR 0.60 (20/80) (p<0.0001). The mean CMT decreased from 374.05 µm ± 103.81 at baseline to 269.04 ± 84.014 at 24 months (p<0.0001).
Both macular grid laser photocoagulation and repeated intravitreal injections of bevacizumab are effective in the primary treatment of DDME. There were no statistically significant differences between both treatment modalities in terms of BCVA and CMT at 24 months of follow-up.
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