Bevacizumab For Diabetic Macular Edema After Standard Laser Treatment

1. Indars Lacis
2. Igor Solomatin
3. Jana Gertner
4. Aida Macijevska

Dr Solomatin's Eye Center, Riga, Latvia

Purpose: Diabetic maculopathy is the leading cause of visual impairment in the working-age population in developed countries. So far Diabetic Macular Edema (DME) is treated by laser, vitreoretinal surgery, and intravitreal cortisone injections. Still in many cases DME do not respond to the treatment. The purpose of this study was to evaluate the additional therapeutic effect of intravitreal bevacizumab injection for patients with persistent DME after standard laser treatment.

Methods: This prospective study included 18 patients (32 eyes) with persistent DME despite of previously received standard laser treatment (according to Early Treatment Diabetic Retinopathy Study protocol recommendations). All patients received single intravitreal injection of 1.25mg/0.05ml bevacizumab. Medical records - visual acuity (BCVA), OCT (macular thickness) were reviewed before treatment and after at weeks 4 and 12.

Results: The mean baseline BCVA was 0.12. Final BCVA analysis demonstrated that 39% eyes remained stable (BCVA improvement less than 1 line), 57% BCVA improved for one or more lines, and (4%) decreased. Mean central macular thickness at baseline by OCT was 389.0 µm and decreased to a mean of 275.7 at end of follow-up. There was a correlation between visual acuity improvement and mean macular thickness decrease. No ocular or systemic adverse events were observed.

Conclusion: Intravitreal bevacizumab injection seems to provide additional short-term therapeutic effect for patients with persistent DME after standard laser treatment. Multiple injections and longer follow-up period would be beneficial for further studies.