Effect of Bevacizumab and Laser in the Management of Diabetic Maculopathy

Abstract

Purpose. To compare the best corrected visual acuity response after repeated intravitreal Bevacizumab and Argon laser alone or in combination in patients with diabetic macular edema.

Material and Methods. One hundred and twenty cases of diabetic macular edema involving the fovea were enrolled for the study. They were randomly divided in 3 groups. Group A received intravitreal Bevacizumab (ivB), Group B Argon laser alone and Group C received both. The follow up was up to 9 months. Main outcome measures were mean average change in best corrected visual acuity (BCVA) and central macular thickness (CMT) from base line until final assessment at 9 months.

Results. The baseline mean ETDRS BCVA was 58.72 ± 10.68 (range 38 – 73) in the ivB group, 55.55 ± 10.75 (range 38 – 69) in laser group and60.12 ± 10.48 (range 38 – 73) in ivB + laser group. The mean ETDRS BCVA at month 9 was68.51 ± 8.59 (range 49 – 74) in the ivB group, 56.08 ± 12.63 (range 38 – 74) in laser group and 70.2 ± 8.74 (range 49 – 78) in ivB + laser group (P =0.000). At 9 months, central macular thickness decreased from 411.7 ± 96.38 (range 296 – 626) at baseline to 249.65 ± 65.37 (range 193 – 454) in ivB group, 413.03 ± 96.38 (range 302 – 615) to 364.92 ± 107.11 (range 206 – 588) in laser group and 415.9 ± 97.50 (range 299 – 649) to 244.8 ± 60.83 (range 193 – 488) in ivB + laser group (P= 0.000).

Conclusion. Bevacizumab alone or in combination with argon laser provide better gain in BCVA as compared to laser alone in patients with diabetic macular edema.