Abstract
Purpose: :
To report the 12-month anatomic and ETDRS best-corrected visual acuity (BCVA) response after primary intravitreal bevacizumab (Avastin®) (1.25 mg or 2.5 mg) in patients with diffuse diabetic macular edema (DDME). In addition, a comparison of the 2 different doses of intravitreal bevacizumab (IVB) utilized was made.
Methods: :
We reviewed the clinical records of 82 consecutive patients (101 eyes) with DDME in this interventional retrospective multicenter study at 6 centers from 5 countries. All patients with a minimum follow-up of 12 months (mean 59.4 ± 6.1.2 weeks) were included in this analysis. Patients underwent ETDRS best-corrected visual acuity (BCVA) testing, ophthalmoscopy, optical coherence tomography (OCT), and fluorescein angiography (FA) at baseline and follow-up visits.
Results: :
The mean age of our patients was 59.7 ± 9.3 years. The mean number of IVB injections per eye was 3 (range:1 to 10). In the 1.25 mg group, at 1 month there was an average gain of 3.2 ± 2.9 lines of BCVA, at 3 months 2.7 ± 2.6 lines of BCVA, at 6 months 2.1 ± 3.4 lines of BCVA and 2.9 ± 3.6 lines of BCVA at 12 months (p<0.005). In the 2.5 mg group, at 1 month eyes gained 2.0 ± 4.0 lines of BCVA, 1.9 ± 2.9 lines of BCVA at 3 months, 0.6 ± 5.5 lines of BCVA at 6 months and 0.7 ± 5.5 lines of BCVA at 12 months (p<0.05). In the 1.25 mg group, the mean central macular thickness (CMT) decreased from 419.1 ± 201.1 µm at baseline to 295.11 ± 91.5 µm at 1 month, 302.1 ± 124.2 µm at 3 months, 313.4.1 ± 96.3 µm at 6 months and 268.2 ± 95.5 µm at 12 months (p<0.0001). In the 2.5 mg group, the mean CMT decreased from 387.7 ± 162 µm at baseline to 287 ± 136 µm at 1 month, 316.9 ± 169.8 µm at 3 months, 306.7 ± 139.6 µm at 6 months and 295,5 ± 113.9 µm at 12 months (p<0.0001). Adverse events included transient high blood pressure in 1 (1.2%) patient, transient increased intraocular pressure in 1 (1%) eye, and tractional retinal detachment in 1 (1%) eye.
Conclusions: :
Primary IVB at doses of 1.25 to 2.5 mg seem to provide stability or improvement in BCVA, OCT, and FA in DDME at 12 months. There seems to be no difference on our results between IVB at doses of 1.25 mg or 2.5 mg.
Keywords: diabetes • retina • edema