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N. V. Potapova, K. Taba; Intravitreal Bevacizumab (Avastin) as an Alternative for Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3476.
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To study the efficacy and safety of intravitreal injection of Avastin as an alternative treatment for DME. We only used Bevacizumab in the patients with prior failure of IVK and/or focal macular laser photocoagulation and in patients with glaucoma on maximal medical therapy or with prior trabeculectomy
6 eyes were treated with the 1.25 mg/0.05 ml of intravitreal Avastin and followed up at least for 60 days. Visual acuity, central foveal thickness by OCT and IOP were recorded before and after the procedure. All patients were male, average age of 57 years. 75% of the eyes had prior FML. On average, the number of FML per eye was 1.2, the number of prior IVK per eye was 2.0. All patients had prior IVK which failed to improve the DME; one patient developed steroid-induced glaucoma that required maximal medical therapy; one patient developed uncontrolled IOP on medical therapy that necessitated glaucoma filtering surgery for IOP control.
Before the intravitreal injection of Avastin, average visual acuity was 20/100 (range 20/400 to 20/80 ), average central foveal thickness was 534 microns and average IOP was 14 mm Hg. 30 days after the injection, average visual acuity was 20/80 (range 20/40 to 20/100), average central foveal thickness was 420 microns, average IOP was 13 mm Hg. No adverse side effects associated with the injection were noted. One patient failed intravitreal Bevacizumab, he had significant ischemic maculopathy on fluorescein angiography seen prior to the Avastin injection.
Intravitreal injection of Avastin appears to be a safe and effective procedure for the treatment of DME, especially in eyes that failed other therapies or have contraindications to steroid treatment. We are continuing to follow and enroll patients to determine the optimal interval for repeated intravitreal Avastin injections.
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