Veronika Aslanova, Nikolai Umanets (Odessa, Ukraine)

Advantages:

Intravitreal bevacizumab injection lead to a significant visual improvement in patients with diabetic macular edema soon after procedure.

Methods:

28 patients (36 eyes), (24 females, 4 males), mean age 62 y/o, with diabetic macular edema were consecutively enrolled in the noncomparative prospective case series. The patients were included in the study independently from the diabetes type, visual acuity (VA), retinal thickness and kind of previous treatment. Complete eye examination included VA, slit lamp and eye fundus examination, intraocular pressure measurement, retinal thickness measurement (OCT), fluorescein angiography and eye fundus photography. 12 patients    had been previously treated as follows: 7 patients (26,9 %) had received laser treatment, 3 (11,5 %) had undergone vitrectomy without ILM peeling, 2 (7,7 %) had received intravitreal triamcinolone injection without any visual improvement. All patients enrolled in our study received intravitreal bevacizumab injection (1.25 mg).

Effectiveness / Safety:

Main outcome measures were: VA and central macular thickness (CMT). Mean CMT before intravitreal bevacizumab injection was 460 microns. One week after injection mean CMT decreased to 283 microns and to 270 microns after one month. Mean VA before treatment was 0.14 and improved to 0.3 one week after injection. This improvement was maintained throughout the 3rd, 6th and 12th month follow-up in 22 patients. In 5 cases a repeat bevacizumab injection was needed because of VA decrease after 10 months in 2 cases, 3 months in one and 2 months in one case.  In 5 cases unilateral intravitreal bevacizumab had an effect on the untreated fellow eye with VA improvement and CMT decrease  (by OCT data). No ocular or systemic adverse events were observed.

Take home message:

Management with intravitreal bevacizumab in patients with diabetic macular edema can be effective in the short term and even for relatively long follow-ups without repeated injections.