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S. Petroni, A. M. Minnella, A. Scupola, L. Ziccardi, M. C. Savastano, P. Sasso, G. Stifano, G. Zinzanella, D. Marangoni, E. Balestrazzi; Intravitreal Bevacizumab in the Treatment of Macular Edema - A Interventional Pilot Study. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1418.
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To evaluate the efficacy and safety of intravitreal injections of bevacizumab in diabetic and vascular (following central or branch vein occlusion) macular edema
This case series study included 15 eyes of patients with diabetic (n=9, mean age 62,3; DS 8,1) and vascular (n= mean age 53,2 DS 15,7) macular edema refractory to conventional therapy. All eyes were treated with intravitreal injections of bevacizumab (0,05ml, 1,25 mg), with a mean of 2 retreatments, and longitudinally evaluated before and after the treatment by serial clinical, OCT and FERG measurements, as well as fluorescein angiography, over a six month period. Macular retinal thickness was determined by the standard OCT 3 Stratus algorithm. FERGs were recorded in response to an 18 degrees flickering stimulus modulated sinusoidally at 41 Hz. Response amplitude and phase were monitored. The fellow uninjected eyes of patients served as control.
Compared to baseline, mean retinal thickness, mean FERG amplitude and visual acuity significantly improved at 15 day from the injection in both groups, and gradually started to worsen at the end of follow-up (six months) in diabetic macular edema group of patients with a mean gain of 2 ETDRS letters and a mean reduction of 39 micron foveal macular thickness. In patients with vascular macular edema we found at six month follow-up a stabilization of the same parameters compared to baseline, with an mean gain of 8 ETDRS letter and a mean gain of 167 microns foveal macular thickness.
Results indicate that intravitreal bevacizumab induces short-term beneficial changes in both macular structure and function in eyes with diabetic and vascular macular edema, and suggest that this treatment is avoid of toxic effects on the outer neural retina. Six month follow up data indicate a good response only in vascular macular edema but not in diabetic macular edema
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