Study supports use of anti-VEGF in center-involving diabetic macular edema

Michaelides M.Ophthalmol. 2010;117:1078-1086.

Patients with center-involving diabetic macular edema treated with intravitreal bevacizumab were five times more likely to gain improvements in distance visual acuity tests at 1 year compared with patients treated with laser, according to a study.

Both visual and anatomical outcomes were improved among patients treated with bevacizumab (Avastin, Genentech) in the randomized, prospective, masked, single-center trial. At 1 year follow-up, best corrected visual acuity improved a median eight Early Treatment Diabetic Retinopathy Study (ETDRS) letters (55.7 letters at baseline to 61.3 letters at 1 year) among bevacizumab-treated patients, whereas best-corrected visual acuity decreased a median 0.5 letters (54.6 letters at baseline to 50 letters at 1 year) among laser-treated patients.

Central macular thickness among patients in the bevacizumab group improved from 507 mcm at baseline to 378 mcm at 1 year. In the laser group, central macular thickness also improved, but to a lesser extent: 481 mcm vs. 413 mcm.

In the study, patients were randomized to either intravitreal bevacizumab administered at baseline, 6 weeks and 12 weeks, with subsequent doses determined by outcomes on optical coherence tomography, or macular laser therapy at baseline followed by re-evaluation every 4 months, with re-treatment determined by previously published ETDRS guidelines.

The median number of injections in the bevacizumab group was nine, and the median number of laser treatments in the macular laser therapy group was three.

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