Interest of Intravitreal Bevacizumab Injection for Diabetic Macular Edema

Abstract

Purpose: : to evaluate action of Bevacizumab on diabetic macular edema

Methods: : we propose to evaluate Bevacizumab intravitreal action in 30 patients with PPR and diabetic macular edema and to folow macular edema evolution at one month and 6 months. Five patients had also simultaneous subtenon dexamethason injection. This small subgroup had triamcinolone intravitreal and subtenon injections in the past. Clinical examination with ETDRS, fluorescein angiography and optic coherence tomography (OCT) were done before injection and at one month. At 6 months, ETDRS and OCT control were realised.

Results: : on 30 patients, 21 (70%) presented some regression of macular edema. In 30% cases no effect was observed on macular edema. One patient presented severe tractional retinal detachment after injection. No retinal ischemia or atrophy and no intraocular inflammation was noticed because of injection. 30% of patients had undergone a triamcinolone intravitreal injection previously and had persistant macular edema before decision to inject bevacizumab intravitreally. This group often showed just diminishment of edema dome by one third at least (90%),but complete resolution of edema was rare (10%).Better resolution of diabetic edema showed the group of intravitreal bevacizumab injection combined with subtenon dexamethason injection where reduction of the edema was higher by 10% than single bevacizumab injection.

Conclusions: : Intravitreal injection of bevacizumab is an alternative therapeutic solution of resistant diabetic macular edema. It must be used with caution in diabetic edema after PPR and risk must be evaluated on a biger trial.

Keywords: retina • diabetes