Abstract
Purpose: :
To evaluate the combined effect of Bevacizumab and Pars plana vitrectomy to stabilize retinal thickness and visual acuity in diffuse diabetic macular edema. (pilot study)
Methods: :
Prospective, randomized, longitudinal study. We recruited patients with diagnosis of diabetes mellitus type 2, older than 25 yo, with diffuse diabetic macular edema with or withour prior treatment, without subfoveal exudates. A complete ophthalmological evaluation was done, and outcome measures were best corrected visual acuity (BCVA) by ETDRS and retinal thickness by optical coherence tomography at baseline, one month and third month. All patients underwent pars plana vitrectomy and bevacizumab injection (2.5 mg/0.1ml). There were 2 groups, group 1: Patients without renal disease. Group 2: Patients with renal disease.
Results: :
We studied 10 patients every single group. Both groups showed improvement in BCVA and decreased retinal thickness, however, in diabetic nephropathy patients their improvement were less evident. P was not statistically significant.
Conclusions: :
Combined therapy of Vitrectomy and Bevacizumab could be a safe and effective treatment to control diffuse diabetic macular edema even without evidence of macular traction at three month follow-up, but further studies are necessary to determine long-term efficacy.
Clinical Trial: :
www.clinicaltrials.gov APEC-ret
Keywords: macula/fovea • edema • diabetic retinopathy