Effect of intravitreal bevacizumab in diabetic macular edema

Objective: To report the effect of intravitreal bevacizumab (Avastin) on visual acuity and central macular thickness in patients with diabetic macular edema (DME), who have already received macular laser photocoagulation. Methodology: This Prospective, interventional case series study was conducted at the Department of Ophthalmology, Isra University and Hospital, Hyderabad, and Al-lbrahim Eye Hospital, Karachi, from July 2009 to March 2010. Twenty four eyes with diffuse DME were treated with intravitreal injection of bevacizumab 1.25mg in 0.05ml. Evaluation at baseline and follow-up visits included visual acuity by ETDRS chart, slit lamp examination, applanation tonometry, fundus fluorescein angiography, and macular thickness measurement by optical coherence tomography. Central macular thickness on optical coherence tomography (OCT) and best corrected visual acuity were measured at baseline and at one month and three months after the intravitreal injection. Results: At baseline, the mean BCVA was 1.033 +/- 0.16 logMAR. This improved to 0.90 +/- 0.22 (p=<0.0001) and 0.94 +/- 0.20 logMAR (p=0.001) at one month and three months, respectively. Mean central macular thickness was 520.40 +/- 139.1 pm at baseline, which decreased to 385.90 +/- 98.30 mu m (p<0.0001) at one month and to 427.40 +/- 112.6 mu m (p=<0.0001) at three months. Conclusion: Intravitreal bevacizumab injection results in significant improvement in visual acuity and reduction in central macular thickness to produce a clinically meaningful and statistically significant benefit in patients with DME; this beneficial effect was shown to persist for up to three months.