Intravitreal bevacizumab injection alone or combined with macular photocoagulation compared to macular photocoagulation as primary treatment of diabetic macular edema
Background/Aim. Within diabetic retinopathy (DR), diabetic macular edema (DME) is one of the leading causes of the loss of visual acuity. The aim of this study was to determine the efficacy of the intravitreal vascular endothelial growth factor (VEGF) inhibitor application alone or combined...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Military Health Department, Ministry of Defance, Serbia
2015-01-01
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| Series: | Vojnosanitetski Pregled |
| Subjects: | |
| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2015/0042-84501500074J.pdf |
| Summary: | Background/Aim. Within diabetic retinopathy (DR), diabetic macular edema
(DME) is one of the leading causes of the loss of visual acuity. The aim of
this study was to determine the efficacy of the intravitreal vascular
endothelial growth factor (VEGF) inhibitor application alone or combined
with macular focal/grid lasephotocoagulation compared with laser treatment
alone. Methods. This prospective randomized clinical trial included 72
patients (120 treated eyes) with varying degrees of DR and DME. The DME
treatment included intravitreal VEGF inhibitor bevacizumab (Avastin®)
application, with and without laser treatment. Bevacizumab (1.25 mg/0.05 mL)
was administered intravitreally in 4-6-week intervals. Laser is applied 4-6
weeks after last dose of the drug as a part of combined treatment, or as the
primary treatment. Results. The mean reduction in central macular thickness
(CMT) for the eyes (n = 31) treated with bevacizumab alone was 162.23 μm,
for the eyes (n = 53) treated with combined treatment the mean reduction in
CMT was 124.24 μm, both statistically significant at p < 0.001. Laser
macular photocolagulation as a part of combined treatment (in 53 eyes)
significantly contributed to the CMT reduction, based on the paired t-test
results (366.28 vs 323.0 μm at p < 0.05). In our study, the mean visual
acuity improvement of 0.161 logMAR was achieved in the group of eyes treated
with bevacizumab alone, and 0.093 logMAR in the group with combined
treatment, both statistically significant at p < 0.05. The effect of laser
photocolagulation alone on visual acuity and CMT was not statistically
significant. Conclusion. Treatment with bevacizumab alone or within combined
treatment is more effective in treating DME than conventional macular laser
treatment alone, both anatomically and functionally. |
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| ISSN: | 0042-8450 2406-0720 |