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P. Sabella, L. Bonavia, S. Luccarelli, C. Luiselli, G. Staurenghi; Intravitreal Bevacizumab (IVB) for Diabetic Macular Edema (DME). Invest. Ophthalmol. Vis. Sci. 2008;49(13):3481. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy of intravitreal bevacizumab for diabetic macular edema.
This prospective consecutive noncomparative case series included 29 consecutive eyes of 21 patients (7 females), with DME; mean age was 63 years (range 47-79). Inclusion criteria were: 1) Snellen acuity equivalent ranging from 20/32 to 20/250, 2) optical coherent tomography (OCT) central subfield thickness (CST) of 300 micron or more. Exclusion criteria were: 1) treatment for DME at any time within the prior 6 months, 2) OCT findings of epiretinal macular membrane or vitreomacular traction, 3) pathological enlargement of the foveolar avascular zone in fluorescein angiography (FA), 4) cataract surgery in the previous 12 months. During the study all patients received only one intravitreal injection.
All patients completed 11-14 weeks of FU. At baseline mean CST by OCT +/- SD was 494 +/-124.9(range, 302-763 micron) and mean BCVA +/- SD was 0.782 +/-0.324(logarithm of the minimum angle of resolution, logMAR). After 4-6 weeks mean CST by OCT +/- SD decreased to 432 +/-131.8, and to 439 +/-153.5 after 11-14 weeks. After 4-6 weeks mean BCVA +/- SD increased to 0.657 +/- 0.307 logMAR, and to 0.655 +/-0.268 logMAR after 11-14 weeks.Aftert 4-6 weeks only 12 of 29 eyes (41%) had an OCT-CST reduction of more than 11% (reliability limit) from the baseline, with a mean reduction +/- SD of 26.2% +/-11.4 (range 12-48%). After 11-14 weeks only 15 of 29 eyes (52%) had an OCT-CST reduction of more than 11% from the baseline, with a mean reduction +/- SD of. 25.8% +/-10.82 (range 15-44%).
These results suggest that one intravitreal injection of bevacizumab is not always associated with an improvement in CST and in BCVA. In our cases a reduction of OCT-CST of more than 11% (reliability limit) is present in 42% at 4-6 w and in 52% at 11-14 w. The visual improvement is present in 64% of patients at 4-6 weeks, and in 58% of patients at 11-14 weeks.Further prospective and randomized studies will be needed to better determine which patients benefit the most from IVB and how often the injection should be administered.
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