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Study supports use of anti-VEGF in center-involving diabetic macular edema
Ophthalmol. 2010;117(6):1078-1086.e2.
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Patients with center-involving diabetic macular edema treated with intravitreal bevacizumab were five times more likely to gain 10 or more ETDRS letters at 1 year compared with patients treated with laser, according to a study.
Both visual and anatomical outcomes were improved among patients treated with Avastin (bevacizumab, Genentech) in the randomized, prospective, masked, single-center trial. At 1 year follow-up, best corrected visual acuity improved a median eight ETDRS letters (mean 55.7 letters at baseline to mean 61.3 letters at 12 months) among bevacizumab-treated patients, whereas BCVA decreased a median 0.5 letters (mean 54.6 letters at baseline to mean 50 letters at 12 months) among laser-treated patients.
Central macular thickness among patients in the bevacizumab group improved from 507 µm at baseline to 378 µm at 12 months. In the laser group, central macular thickness also improved, but to a lesser extent: 481 µm vs. 413 µm.
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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