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Bevacizumab in diabetic macular edema. A retrospective analysis of the efficacy of treatment in a group of 100 patients
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Abstract
INTRODUCTION. The aim of the study was to retrospectively evaluate the efficacy of intravitreal injections of bevacizumab in a large group of diabetic macular edema (DME) patients.
MATERIA LS AND METHODS. One hundred patients (125 eyes) suffering from diabetes type 1 or 2 and DME were treated with two or three monthly 1.25-mg intravitreal injections of bevacizumab.
RESULTS . The mean (SD) best correct visual acuity (BCVA) before treatment was 63.8 (± 26.2) letters. At months 1, 2, and 3 the mean change (SE) in BCVA from baseline was +4.4 (± 0.49), +4.9 (0.38), and +3.1 (± 0.39) letters, respectively. The mean macular retinal thickness dropped from 457 (± 183) microns to 308 (± 122) microns after three months. The improvement of retinal morphology in optical coherence tomography was evident: a decrease in the number of intraretinal cysts and a generalised shrinkage of retinal macular edema. There were no serious adverse effects of the treatment.
CONCLUSION. The majority of patients with DME showed an improvement in visual acuity, particularly after the first injection of bevacizumab. Bevacizumab therapy is an interesting alternative to DME treatment.
Abstract
INTRODUCTION. The aim of the study was to retrospectively evaluate the efficacy of intravitreal injections of bevacizumab in a large group of diabetic macular edema (DME) patients.
MATERIA LS AND METHODS. One hundred patients (125 eyes) suffering from diabetes type 1 or 2 and DME were treated with two or three monthly 1.25-mg intravitreal injections of bevacizumab.
RESULTS . The mean (SD) best correct visual acuity (BCVA) before treatment was 63.8 (± 26.2) letters. At months 1, 2, and 3 the mean change (SE) in BCVA from baseline was +4.4 (± 0.49), +4.9 (0.38), and +3.1 (± 0.39) letters, respectively. The mean macular retinal thickness dropped from 457 (± 183) microns to 308 (± 122) microns after three months. The improvement of retinal morphology in optical coherence tomography was evident: a decrease in the number of intraretinal cysts and a generalised shrinkage of retinal macular edema. There were no serious adverse effects of the treatment.
CONCLUSION. The majority of patients with DME showed an improvement in visual acuity, particularly after the first injection of bevacizumab. Bevacizumab therapy is an interesting alternative to DME treatment.
Keywords
bevacizumab, diabetic retinopathy, intravitreal injections, macular edema, optical coherence tomography, vascular endothelial growth factor A
About this articleTitle
Bevacizumab in diabetic macular edema. A retrospective analysis of the efficacy of treatment in a group of 100 patients
Journal
Issue
Article type
Original paper
Pages
1-5
Published online
2017-03-22
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778
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1456
DOI
Bibliographic record
Ophthalmol J 2017;2(1):1-5.
Keywords
bevacizumab
diabetic retinopathy
intravitreal injections
macular edema
optical coherence tomography
vascular endothelial growth factor A
Authors
Piotr Kanclerz
Andrzej Grzybowski
Rafał Ściegienny
References (21)- Ferris FL, Patz A. Macular edema. A complication of diabetic retinopathy. Surv Ophthalmol. 1984; 28 Suppl: 452–461.
- World Health Organization. Global Report On Diabetes 2016. http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf?ua=1..
- NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet. 2016; 387(10027): 1513–1530.
- Klein R, Klein B, Moss S, et al. The Wisconsin epidemiologic study of diabetic retinopathy: XVII. Ophthalmology. 1998; 105(10): 1801–1815.
- Progression of retinopathy with intensive versus conventional treatment in the Diabetes Control and Complications Trial. Diabetes Control and Complications Trial Research Group. Ophthalmology. 1995; 102(4): 647–661.
- Lee R, Wong TY, Sabanayagam C. Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye Vis (Lond). 2015; 2: 17.
- Yilmaz T, Cordero-Coma M, Gallagher MJ, et al. Systematic review of intravitreal bevacizumab injection for treatment of primary diabetic macular oedema. Acta Ophthalmol. 2011; 89(8): 709–717.
- Zechmeister-Koss I, Huic M. Vascular endothelial growth factor inhibitors (anti-VEGF) in the management of diabetic macular oedema: a systematic review. Br J Ophthalmol. 2012; 96(2): 167–178.
- Michaelides M, Kaines A, Hamilton RD, et al. A prospective randomized trial of intravitreal bevacizumab or laser therapy in the management of diabetic macular edema (BOLT study) 12-month data: report 2. Ophthalmology. 2010; 117(6): 1078–1086.e2.
- Wells JA, Glassman AR, Ayala AR, et al. Diabetic Retinopathy Clinical Research Network. Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema. N Engl J Med. 2015; 372(13): 1193–1203.
- Ahmadieh H, Ramezani A, Shoeibi N, et al. Intravitreal bevacizumab with or without triamcinolone for refractory diabetic macular edema; a placebo-controlled, randomized clinical trial. Graefes Arch Clin Exp Ophthalmol. 2008; 246(4): 483–489.
- Soheilian M, Ramezani A, Obudi A, et al. Randomized trial of intravitreal bevacizumab alone or combined with triamcinolone versus macular photocoagulation in diabetic macular edema. Ophthalmology. 2009; 116(6): 1142–1150.
- Sivaprasad S, Crosby-Nwaobi R, Esposti SD, et al. Structural and functional measures of efficacy in response to bevacizumab monotherapy in diabetic macular oedema: exploratory analyses of the BOLT study (report 4). PLoS One. 2013; 8(8): e72755.
- Joshi L, Bar A, Tomkins-Netzer O, et al. Intravitreal bevacizumab injections for diabetic macular edema - predictors of response: a retrospective study. Clin Ophthalmol. 2016; 10: 2093–2098.
- Virgili G, Parravano M, Menchini F, et al. Anti-vascular endothelial growth factor for diabetic macular oedema. Cochrane Database Syst Rev. 2014(10): CD007419.
- Virgili G, Parravano M, Menchini F, et al. Antiangiogenic therapy with anti-vascular endothelial growth factor modalities for diabetic macular oedema. Cochrane Database Syst Rev. 2012; 12: CD007419.
- A Systematic Review of Intravitreal Bevacizumab for the Treatment of Diabetic Macular Edema. https://www.ncbi.nlm.nih.gov/pubmed/27195370.
- Li E, Greenberg PB, Voruganti I, et al. Cost and Selection of Ophthalmic Anti-Vascular Endothelial Growth Factor Agents. R I Med J (2013). 2016; 99(5): 15–17.
- Ladas ID, Karagiannis DA, Rouvas AA, et al. Safety of repeat intravitreal injections of bevacizumab versus ranibizumab: our experience after 2,000 injections. Retina. 2009; 29(3): 313–318.
- Fintak DR, Shah GK, Blinder KJ, et al. Incidence of endophthalmitis related to intravitreal injection of bevacizumab and ranibizumab. Retina. 2008; 28(10): 1395–1399.
- Wu L, Martínez-Castellanos MA, Quiroz-Mercado H, et al. Pan American Collaborative Retina Group (PACORES). Twelve-month safety of intravitreal injections of bevacizumab (Avastin): results of the Pan-American Collaborative Retina Study Group (PACORES). Graefes Arch Clin Exp Ophthalmol. 2008; 246(1): 81–87.