Resolution of Macular Oedema in Diabetic Patients Following Avastin (Bevacizumab) Intravitreal Therapy
Purpose: To estimate the effectiveness of intravitreal Avastin (bevacizumab) treatment in the reduction of macular oedema in diabetic patients.
Study Design: Prospective Cohort study.
Place Duration of study: Outpatient department (OPD) of the Ophthalmology department of Liaquat National Hospital (LNH) between the period April 2013 March 2015.
Material Methods: A total of 66 eyes of 44 patients (both type 1 type 2 diabetics) were selected who were advised their first intraocular Avastin in one or both eyes with clinically visible angiographically confirmed macular oedema and those who did not have a prior history of grid laser photocoagulation. All subjects were treated by intravitreal avastin (bevacizumab) 1.25 mg injection. Best-corrected visual acuity, slit lamp examination and fundus fluorescein angiography were examined before after intravitreal injection.
Results: A total of 66 eyes of 44 patients (both type I Type II diabetes) without any prior history of Avastin were included in the study. There were 26 (59%) males 18 (41%) females. The edema was seen completely resolved in 8 patients (12.2%), partially resolved 44 (66.7%) not resolved in 14 (21.21%). There was no adverse reaction seen in any eye except four eyes had mild anterior chamber inflammation which were treated with topical corticosteroid and one eye developed sub-conjunctival haemorrhage. The visual acuity improved in 59 out of 66 eyes (89%) based on the increased number of lines read by the patient on Snellen chart and in only 7 eyes there was no improvement during a mean follow-up period of 6 months.
Conclusion: Intravitreal bevacizumab injection provides significant improvement in visual acuity as well as reduction of macular oedema therefore may consider as a primary treatment of diabetic macular oedema.
Keywords: Anti-vascular endothelial growth factor; Bevacizumab; Diabetic macular edema; Diabetic retinopathy.