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Anti-VEGF beneficial in eyes with refractory DME and no prior vitrectomy
Ophthalmic Surg Lasers Imaging. 2010;41(3):323-329.
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Intravitreal injection of anti-VEGF therapy improves vision while resolving architectural defects in patients with refractory diabetic macular edema, according to a study.
In a retrospective review of 60 eyes of 54 patients treated with Avastin (bevacizumab, Genentech) for refractory DME, visual acuity improved from 0.71 logMAR at baseline to 0.66 logMAR at final follow-up (minimum 6 months; mean 7.4 months). Central retinal thickness improved from a mean 440 µm at baseline to 386 µm at final follow-up.
Prior therapy with panretinal photocoagulation, periocular or intravitreal steroids, or focal laser photocoagulation did not appear to influence success of therapy with bevacizumab. However, patients who had undergone a previous vitrectomy had a visual acuity after treatment that was 0.254 logMAR higher than patients with no previous vitrectomy.
"Patients who had undergone previous vitrectomy had post-treatment visual acuity almost three Snellen lines worse than those who had not undergone previous vitrectomy," the study authors said. "In patients who have undergone previous vitrectomy, intravitreal bevacizumab does not appear to have a beneficial effect."
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