Intravitreal bevacizumab alone versus combined with macular photocoagulation in diabetic macular edema

Korean J Ophthalmol. 2011 Oct;25(5):299-304. doi: 10.3341/kjo.2011.25.5.299. Epub 2011 Sep 20.

Abstract

Purpose: To compare the efficacy between intravitreal bevacizumab and combination treatment (bevacizumab and macular photocoagulation) for the treatment of diabetic macular edema (DME). In addtion, changes of DME type were researched using optical coherence tomography.

Methods: The present study included 90 eyes with bevacizumab injection and 38 eyes with combination treatment. Using chart records, patients were reviewed until 6 months after treatment. The present study compared changes of visual acuity (VA) and macular thickness at each follow up. DME was classified into 4 types and the morphologic pattern was compared.

Results: In patients with the bevacizumab injection only, VA improved from 0.29 ± 0.18 to 0.48 ± 0.26 at 1 month and returned to 0.32 ± 0.20 at 6 months after treatment. In the combination treatment, VA improved from 0.32 ± 0.22 to 0.52 ± 0.26 at 1 month and returned to 0.36 ± 0.18 at 6 months after treatment. There was no significant improvement of VA at the final follow-up with either treatment. There was significant decrease of macular thickness except in the mixed DME type.

Conclusions: The combination treatment did not yield better VA or macular thickness reduction at 6 months than bevacizumab injection alone. By classifying and observing the change of DME type, determining the treatment objectively and predicting the effectiveness of treatment can be helpful.

Keywords: Bevacizumab; Macular edema; Macular laser photocoagulation.

Publication types

  • Comparative Study

MeSH terms

  • Angiogenesis Inhibitors / administration & dosage
  • Antibodies, Monoclonal, Humanized / administration & dosage*
  • Bevacizumab
  • Diabetic Retinopathy / complications*
  • Diabetic Retinopathy / diagnosis
  • Diabetic Retinopathy / therapy
  • Dose-Response Relationship, Drug
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Fundus Oculi
  • Humans
  • Intravitreal Injections
  • Laser Coagulation / methods*
  • Macular Edema / diagnosis
  • Macular Edema / etiology
  • Macular Edema / therapy*
  • Male
  • Microscopy, Acoustic
  • Middle Aged
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Vascular Endothelial Growth Factor A
  • Bevacizumab