Short-Term Effects of Intravitreal Bevacizumab in Contrast Sensitivity of Patients with Diabetic Macular Edema and Optimizing Glycemic Control

Abstract

Purpose : To analyze contrast sensitivity of intravitreal bevacizumab injections with optimizing glycemic control versus optimizing glycemic control (in combination with sham injections) in eyes with diabetic macular edema (DME)

Methods : Forty-one eyes of 34 patients with type 2 diabetes mellitus and DME with glycated hemoglobin (HbA1c) <11% received either intravitreal bevacizumab injection (Group 1) or sham injection (Group 2) at 0 and 6 weeks along with optimizing glycemic control. Mean change in best-corrected visual acuity (BCVA), contrast sensitivity (CS), optical coherence tomography (OCT)-measured by central macular thickness (CMT) were compared and correlated at baseline, 2, 6 and 12 weeks.

Results : The study showed a mean CS improved in group 1 from 1.14±0.36 logCS to 1.32±0.24 logCS and also in group 2 from 1.11±0.29 logCS to 1.18±0.29 logCS at 12 weeks (P = 0.12). CS and CMT promptly decreased in group 1 compared to group 2 at 2 weeks ( CS improvement = 0.15±0.25 vs. 0.03±0.15 logCS; P = 0.04; CMT improvement = 116±115 vs. 17±71 μm; P = 0.01). There was a mean reduction of approximately 0.5% in HbA1c levels in both groups at 12 weeks (P = 0.002). The correlation between CS vs. BCVA at baseline was negative and statistically significant (r = -0.70; P < 0.001; n=41).

Conclusions : The study suggests the use of bevacizumab in combination with optimizing glycemic control for promptly improvement of contrast sensitivity in type 2 diabetes patients with DME. However, the optimizing glycemic control itself has shown also to be effective at 12 weeks.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Outcome Measures in the Two Treatment Groups

 

Relationship between in patients with diabetic macular edema between Contrast Sensitivity (LogCS) and Visual Acuity (LogMAR - ETDRS)