Intravitreal Bevacizumab (Avastin) for the Treatment of Diabetic-Macular-Edema:-Results-of-the-Pan-American-Collaborative-Retina-Study-Group.swf

J. Fernando Arevalo, MD, FACS (Caracas, Venezuela), Jans Fromow- Guerra, MD, PhD (Mexico City, Mexico), Hugo Quiroz-Mercado, MD (Mexico City, Mexico), Juan G. Sanchez, MD (Caracas, Venezuela), Lihteh Wu, MD (San Jose, Costa Rica), Michel Eid Farah, MD, PhD (São Paulo, Brazil), Mauricio Maia, MD (Sao Paulo, Brazil), Maria H. Berrocal, MD (Santurce, PR)


To report the short-term anatomic and bestcorrected visual acuity (BCVA) response after primary intravitreal bevacizumab (Avastin) in patients with diabetic macular edema (DME).


Interventional retrospective multicenter study in 5 centers from 5 countries of patients with DME who were treated with at least one intravitreal injection of 1.25 mg or 2.5mg of bevacizumab. Patients underwent ETDRS BCVA testing, ophthalmoscopic examination, optical coherence tomography (OCT), and fluorescein angiography (FA) at baseline and follow-up visits. Main outcome measures included changes in BCVA, OCT and FA. Statistical analysis was performed utilizing the paired Student t test.


Eighty-two eyes of 72 consecutive patients with a mean age of 60.4 ± 9.6 years were evaluated. Mean of follow-up was 12.7 ± 4.9 weeks (range from 7 to 31 weeks). Six (7.3%) eyes needed a second injection at a mean of 12.5 weeks (range from 7 to 17 weeks). The mean baseline BCVA was logMAR =-0.83 and the final mean BCVA was logMAR =?-0.59, a difference that was statistically significant (p =?0.0001). Final BCVA analysis by sub-groups demonstrated that 40 (48.8%) eyes remained stable, 40 (48.8%) eyes improved two or more ETDRS lines of BCVA, and 2 (2.4%) eyes decreased two or more ETDRS lines of BCVA. The mean central macular thickness at baseline by OCT was 391.8 μm ± 199.4 μm and decreased to a mean of 267.8 μm ± 121.4 μm at the end of follow-up (p =?0.0001). No ocular or systemic adverse events were observed.


Primary intravitreal bevacizumab at doses of 1.25 mg or 2.5 mg provide stability or improvement in VA, OCT and FA in DME. Follow-up is still short to make any specific treatment recommendations, however it seems promising. Evaluation in a multicenter, randomized, placebo-controlled clinical trial with longer follow-up is needed to determine the efficacy of this new treatment.