Korean J Ophthalmol.  2009 Mar;23(1):17-22. 10.3341/kjo.2009.23.1.17.

Intravitreal Bevacizumab for Treatment of Diabetic Macular Edema

• Seo JW
• Park IW

• KMID: 1115646
• DOI: http://doi.org/10.3341/kjo.2009.23.1.17

Abstract

PURPOSE: To evaluate the effect of intravitreal bevacizumab on visual function and retinal thickness in patients with diabetic macular edema (DME).
METHODS
Thirty eyes of twenty-eight patients (mean age, 57.9+/-13.8 years) with DME were included in this study. Complete ophthalmic examination, including determination of best-corrected visual acuity (BCVA), stereoscopic biomicroscopy, and retinal thickness measurement by optical coherence tomography (OCT), was done at baseline and at each follow-up visit. All patients were treated with a 0.05 mL intravitreal injection containing 1.25 mg of bevacizumab.
RESULTS
All patients completed 3 months of follow-up with a mean follow-up period of 5.26+/-2.39 months. The mean BCVA at baseline was 0.73+/-0.36 logMAR, which significantly improved to 0.63+/-0.41 (p=0.02), 0.58+/-0.36 (p=0.003), and 0.61+/-0.40 logMAR (p=0.006) at 1 week, 1 month, and 3 months. Final BCVA analysis demonstrated that 15 eyes (50%) remained stable and 12 (40%) improved > or =2 lines on BCVA. The mean central retinal thickness was 498.96+/-123.99 microm at baseline and decreased to 359.06+/-105.97 (p<0.001), 334.40+/-121.76 (p<0.001), 421.40+/-192.76 microm (p=0.035) at 1 week, 1 month, and 3 months. No ocular toxicity or adverse effects were observed.
CONCLUSIONS
Intravitreal bevacizumab injection resulted in significant improvement in BCVA and central retinal thickness as early as 1 week after injection in patients with DME, and this beneficial effect persisted for up to 3 months. However, the slight reduction in this improvement at 3 months suggests that repeated bevacizumab injections might be necessary. To evaluate the long-term safety and efficacy, further prospective randomized controlled clinical trials will be needed.

Keyword

Diabetic macular edema; Intravitreal bevacizumab injection

MeSH Terms

Angiogenesis Inhibitors/*administration & dosage
Antibodies, Monoclonal/*administration & dosage
Diabetic Retinopathy/*drug therapy/pathology
Female
Follow-Up Studies
Humans
Injections
Laser Therapy/methods
Macular Edema/*drug therapy/pathology
Male
Middle Aged
Retrospective Studies
Time Factors
Tomography, Optical Coherence
Treatment Outcome
Vascular Endothelial Growth Factor A/antagonists & inhibitors
Visual Acuity
Vitrectomy/methods
Vitreous Body

Figure

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  Fig. 1 Changes in best-corrected visual acuity (BCVA) and central retinal thickness measured by optical coherence tomography (OCT) after intravitreal bevacizumab injection.

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  Fig. 2 Development of visual acuity (logMAR) evaluated after 1 month (A) and 3 months (B) of follow-up.

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  Fig. 3 Development of central retinal thickness measured by optical coherence tomography after 1 month (A) and 3 months (B) of follow-up.

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