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S. Mehta, K. J. Blinder, G. K. Shah, S. Kymes; Intravitreal Bevacizumab for the Treatment of Refractory Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3488.
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To report the effect of intravitreal bevacizumab on visual acuity (VA) and central retinal thickness (CRT) in patients with refractory diabetic macular edema (DME).
Medical records of 60 eyes of 54 patients who had undergone intravitreal bevacizumab therapy for refractory DME were reviewed. All eyes received at least one intravitreal injection of bevacizumab 1.25 mg/0.05 ml and 36 eyes underwent pre- and post-treatment optical coherence tomography (OCT).
Mean follow up was 6 months, with a range of 3-17 months. All eyes had undergone previous treatments, such as focal laser therapy (83%), sub-tenons triamcinolone (22%), intravitreal triamcinolone (47%), full-scatter panretinal laser therapy (PRP) (40%), and vitrectomy (28%). Baseline mean VA +/- standard deviation was 0.71 +/- 0.28 logMAR of Snellen letters. At the final follow-up visit, mean VA had improved to 0.65 +/- 0.30 logMAR of Snellen letters (p = 0.034). Of eyes that had an improvement in VA of ≥ 1 Snellen line, significantly fewer had undergone prior vitrectomy (p = 0.0169) or prior PRP (p = 0.0227) when compared to eyes with no improvement or worsening of VA. Although there were trends toward improvement in VA in eyes who had not undergone prior steroid injections or cataract surgery, they did not achieve statistical significance. Baseline mean CRT was 440 +/- 106 microns, and mean CRT after bevacizumab treatment was 386 +/- 129 microns (p=0.0077). The only baseline characteristic predictive of a CRT reduction of ≥ 50 microns was phakic lens status (0.0402). There was no significant relationship between improvement in VA and decrease in CRT.
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