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M. S. Tonz, C. K. Brinkmann, M. Frey, S. Wolf, U. E. K. Wolf-Schnurrbusch; Short-Term Effects After Intravitreal Application of Bevacizumab in Patients With Diabetic Macular Edema. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5031.
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We report about short-term effects after intravitreal bevacizumab (Avastin®) (1.25 mg in 0.05 ml) injection in patients with clinically significant diabetic macular edema.
Fifteen eyes with clinically significant macular edema due to diabetes mellitus treated with intravitreal bevacizumab (Avastin® 1.25 mg in 0.05 ml) were included into the study. At baseline, patients underwent a complete ophthalmologic examination including a detailed medical and ocular history. Examinations included ETDRS visual acuity, binocular ophthalmoscopy, OCT III (Stratus, Carl Zeiss Meditec, Jena, Germany), and colour fundus photography (FF 450 plus, Carl Zeiss Meditec, Jena, Germany). Fluorescein angiography with a scanning laser ophthalmoscope (HRA, Heidelberg Eye Explorer, Heidelberg Engineering, Dossenheim, Germany) was done at baseline and at 168 hours. After the injection patients underwent follow-up examinations at 24, 72, and 168 hours (h) including ETDRS visual acuity and OCT III.
Visual acuity increased after 24 h by 2.3 ± 5.9 letters, after 72 h by 7.6 ± 5.1 letters, and after 168 h by 7.1 ± 5.0 letters (baseline: 60.4 ± 13.0 letters vs. 168 h: 67.4 ± 9.8 Letters; p < 0.01). Central foveal thickness was 401 ± 76 microns at baseline, 387 ± 74 microns at 24 h, 372 ± 63 microns at 72 h, and 362 ± 60 microns at 168 h. The reduction of retinal thickness from baseline to the 168 h follow-up was statistically significant.
Intravitreal bevacizumab injection leads to a fast increase in visual acuity in patients with clinically significant diabetic macular edema. The reduction in retinal thickness was not impressive (10%), but may have contributed to the increase in visual acuity. Our data suggest that visual acuity increase precedes the reduction in retinal thickness assessed by OCT.
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