scholarly journals Evaluation of Intravitreal Bevacizumab injection in treatment of diabetic macular edema in eyes with Good visual acuity

2021 ◽  
Author(s):  
seyed aliasghar mosavi
Keyword(s):  
Visual Acuity ◽  
Treatment Group ◽  
Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Control Group ◽  
The Mean ◽  
The Difference ◽  
Good Vision

Abstract Aims To determine the effect of intravitreous Bevacizumab injection on reducing diabetic macular edema in patients with good vision. Method : This clinical trial was conducted on diabetic patients with centrally involved macular edema and good vision over a period of one and a half year. 22 eyes of 12 patients with a visual acuity of Snellen equivalent of 20/25 or better in the non-proliferative stage with the central macular thickness of more than 300 microns in optical coherence tomography (OCT) were evaluated. In the injection group 1.25 Mg of bevacizumab (Avastin) was injected intravitreally and the control group was followed up. Macular thickness and visual acuity were measured in two groups at first and sixth months after injection. Results Intravitreal bevacizumab was injected in 12 eyes (55%) and 10 patients were followed-up as a control group (45%). The mean central macular thickness was 319 µm at first visit and 301 µm at month six in the treatment group and in the control group it was 318 µm and 328 µm respectively. The mean macular thickness of the treatment group was significantly decreased (p = 0.031), but the difference was not statistically significant between two groups (p = 0.581). The mean visual acuity in the treatment group was 0.045 Log MAR at first visit and 0.033 Log MAR at the sixth month follow up, these values in the control group were 0.1 Log MAR and 0.045 Log MAR respectively and did not differ statistically between the two groups (p = 0.373) Conclusion Although the mean macular thickness was reduced in the treatment group with visual acuity of 20/25 or better but the difference was not significant during follow-up at least in a short period. Therefore, the role of underlying factors other than VEGF alone can be notable in the pathogenesis of the disease.

Ranibizumab for Persistent Diabetic Macular Edema after Bevacizumab Treatment

2016 ◽  
Vol 27 (2) ◽  
pp. 210-214 ◽  
Author(s):  
Gabriel Katz ◽  
Elad Moisseiev ◽  
Dafna Goldenberg ◽  
Joseph Moisseiev ◽  
Yosef Lomnicky ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Significant Gain ◽  
Bevacizumab Treatment ◽  
The Mean ◽  
The Difference ◽  
Persistent Diabetic Macular Edema

Purpose To evaluate the efficacy of switching from bevacizumab to ranibizumab in patients with diabetic macular edema (DME). Methods This was a retrospective study of patients with DME initially treated with bevacizumab and switched to ranibizumab. Visual acuity (VA) and central retinal thickness (CRT) were retrieved at fixed timepoints prior to and after the switch. Results Forty eyes of 32 patients were included in the study. The difference in VA between any of these fixed timepoints was not statistically significant. A significant gain in VA was found in eyes that lost more than 0.1 logMAR during treatment with the last 3 bevacizumab injections. The mean CRT was significantly lower after the first 3 ranibizumab injections and at the final follow-up (p<0.001), a 67 ± 14 μm and 78 ± 18 μm reduction in thickness, respectively. Conclusions Switching to ranibizumab resulted in a significant decrease in the CRT of eyes with DME, and should be considered when there is a lack of response or deterioration while on bevacizumab injections. A significant gain in VA was observed in a subgroup of eyes that lost more than one line while receiving the last 3 bevacizumab injections prior to the switch.

scholarly journals Combined Intravitreal Bevacizumab and Laser Photocoagulation to Treat Retinal Arterial Macroaneurysms

2021 ◽  
Vol 62 (8) ◽  
pp. 1053-1060
Author(s):  
Tae Hoon Kim ◽  
Chang Zoo Kim ◽  
Seung Uk Lee ◽  
Sang Joon Lee
Keyword(s):  
Visual Acuity ◽  
Laser Photocoagulation ◽  
Lipid Level ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Intravitreal Bevacizumab Injection ◽  
Photocoagulation Treatment ◽  
The Mean ◽  
Bevacizumab Injection

Purpose: To investigate the effects of intravitreal bevacizumab injection combined with laser photocoagulation in patients with retinal microaneurysms.Methods: We retrospectively reviewed the medical records of 21 eyes of 21 patients who underwent intravitreal bevacizumab injection and/or laser photocoagulation to treat retinal macroaneurysms. Eleven eyes received the combination therapy (CT) and 10 eyes monotherapy (MT) (either bevacizumab injection or laser photocoagulation). Changes in visual acuity, central macular thickness, macroaneurysm size and location, blood pressure, and the lipid level were compared between the two groups.Results: The mean patient age was 74.0 ± 10.5 years and the mean study period 7.0 ± 5.3 months. The mean macroaneurysm diameter of the CT group was 480.00 ± 292.30 μm and that of the MT group 328.75 ± 87.09 μm. The diameter was significantly larger in the CT group (p = 0.002). The initial visual acuities were 0.91 ± 0.66 and 0.88 ± 0.83 in the CT and MT groups, respectively. At the 4-month follow-up, the visual acuities were 0.33 ± 0.26 and 0.17 ± 0.29 in the CT and MT groups, respectively, and had significantly improved only in the CT group (p = 0.042). The initial central macular thicknesses were 441.82 ± 226.81 and 541.63 ± 401.97 μm in the CT and MT groups, respectively. At the 4-month follow-up, the figures were 293.60 ± 46.10 and 269.00 ± 48.34 μm in the CT and MT groups, respectively, and had significantly decreased only in the CT group (p = 0.043). Compared to the initial findings, the proportion of patients whose final visual acuities improved by more than two lines were 73% and 40%, respectively, thus significantly higher in the CT group (p < 0.001).Conclusions: Combined intravitreal bevacizumab injection and laser photocoagulation treatment of retinal macroaneurysms improve visual acuity and decrease macular thickness.

scholarly journals The Difference Of Visual Acuity And Macular Thickness Post Bevacizumab Therapy In Secondary Macular Edema Retinal Vein Occlusion

2018 ◽  
Vol 4 (2) ◽  
pp. 110
Author(s):  
Citra Rahmadani ◽  
Nur Khoma Fatmawati ◽  
Rahmat Bakhtiar
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Secondary Data ◽  
Macular Thickness ◽  
Vein Occlusion ◽  
Before And After ◽  
Quasi Experimental ◽  
The Mean ◽  
The Difference

Retinal vein occlusion is the second most common cause of blindness in retinal vascular disease after diabetic retinopathy and may lead to complications of macular edema. Bevacizumab is an influential treatment as an anti vascular endothelial growth factor (VEGF). This study aims to determine the difference of visual acuity and macular thickness before and after treatment of Bevacizumab. This is a quasi experimental study in patients with secondary macular edema retinal vein occlusion who meets the inclusion criteria. Visual acuity and macular thickness were evaluated after one month of treatment. This study was conducted for two months since May-June 2017 by collecting secondary data from medical record at SMEC Samarinda from January 2016 – June 2017. Data were analyzed using Wilcoxon. Sixteen eyes from 16 patients were diagnosed with macular edema secondary retinal vein occlusion given bevacizumab treatment. The mean visual acuity before therapy was 1.106 LogMAR ± 0.509 and increased to 0.889 logMAR ± 0.608 (p = 0.116) after treatment while the mean macular thickness before therapy was 504.06 μm ± 301.273 and decreased to 348.81 μm ± 181.17 (p = 0.017) after treatment. There was a significant effect on the decrease in macular thickness but no significant effect on visual acuity improvement in patients with macular edema secondary retinal vein occlusion at SMEC Samarinda.  Keywords: Retinal vein occlusion, macular edema, bevacizumab

scholarly journals A Prospective Study of Safety Profile and Efficacy of three doses of Intravitreal Bevacizumab in Diabetic Macular Edema

2021 ◽  
Vol 4 (2) ◽  
pp. 127
Author(s):  
Nasrin Y ◽  
Sharma Ajay ◽  
Sharmila Yalakala
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Therapeutic Agent ◽  
Intravitreal Bevacizumab ◽  
Systemic Complications ◽  
Systemic Side Effects ◽  
The Mean ◽  
A Prospective Study

Introduction: Current study aimed to evaluate efficacy of intravitreal Bevacizumab in Diabetic macular edema, and to identify their ocular and systemic complications if any. Method: It is a prospective, interventional study with 68 patients in 82 eyes with Diabetic macular edema. All treated by 3 injection of intravitreal bevacizumab with 1 month interval. Visual acuity, macular edema, and complications evaluated at every month upto 6th months. Ranibizumab was offered if the patient is a non-respondent to Bevacizumab. Results: Majority age group of 61-70 years with a mean age of 59 ± 6.72 years. The mean duration of diabetes was 11.68 ± 7.2 years. The mean baseline BCVA and CRT are 0.64 ± 0.28 Log MAR units and 436.99 ± 135.10 μm. After 3 injections, BCVA values are 0.48±0.27 (p< 0.01)), 0.36±0.24 (p<0.01)), and 0.27±0.24 (p<0.01), 0.23±0.27 Log MAR (p<0.01)) at 1month, 2 months, and 3 months, and 6 months follow-up respectively. CMT levels are 315.79±124.60 μ at 1 month, after 3rd IVA and this significant change (p<0.01) followed with subsequent follow-up with mean CRT of 296.04±122.97 μ (p< 0.01) at 6th month. The BCVA improved ≥ 2 Snellen lines in 69.5% and 78% cases, resolution of CMT in 56% and 69.5% cases at 3 months and 6 months respectively. At the end of the 3rd month, 46 eyes macular edema completely resolved with 3 injections of IVA, 23 eyes persistent macular edema present, 13 eyes refractory to bevacizumab injections. Persistent & Refractory macular edema eyes (36) switched to Ranibizumab injections.In persistent macular edema, significant resolution (p≤0.01) of macular thickness (370.52 ± 71.43 µm vs. 341.08 ± 122.75 µm) without (p=0.09) improvement in visual acuity (0.45 ± 0.20 vs. 0.34 ± 0.23) was observed post Ranibizumab injections.  In Refractory macular edema, thickness of cases no significant (497.76 ± 161.07µm vs 407.84 ± 169.64 µm) improvement seen after Ranibizumab injections(p=0.1). Recurrence of macular edema seen in 10.9%. Subconjunctival haemorrhage seen in 10.9%-12.1% cases, raised IOP in 2.4%-3.6% cases at post injection day 1. No other ocular and systemic complications were observed during follow-up. Conclusions: Intravitreal bevacizumab is effective in treatment of diabetic macular edema but therapeutic effect is temporary and repeat treatment is needed. It does not show any potential drug related ocular and systemic side effects, hence it is safe and economical therapeutic agent

scholarly journals Outcomes of Intravitreal Bevacizumab for Macular Edema Secondary to Branch Retinal Vein Occlusion

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Nasir Chaudhry ◽  
Sarmad Zahoor ◽  
Usama Iqbal ◽  
Muhammad Owais Sharif ◽  
Muhammad Sharjeel ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Female Ratio ◽  
Vein Occlusion ◽  
Vitreoretinal Traction ◽  
Quasi Experimental ◽  
Study Institute

Purpose: To determine the functional and anatomical outcome of intravitreal Bevacizumab in patients withmacular edema secondary to branch retinal vein occlusion.Study Design: Quasi Experimental study.Place and Duration of Study: Institute of Ophthalmology, Mayo hospital, Lahore, from February 2016 to December 2018.Material and Methods: Forty eyes of 40 patients with macular edema on OCT secondary to BRVO were included in the study. All the patients suffering from other types of macular edemacaused by diabetes, epi-retinal membrane (ERM), surgery involving posterior segment, vitreoretinal traction andhistory of intravitreal VEGF or steroids were excluded from the study. Intravitreal Bevacizumab was given whenmacular thickness was > 300 μm or Visual acuity was < 6/12. Follow-up was at 1st, 3rd, 6th and 12th month.Results: The mean age of the patients was 52.12 ± 5.63 years. Male to female ratio was 1.5:1. Infero-temporalvenous arcade was the most common site of BRVO (55%) followed by supero-temporal (35%) and macularBRVO (10%). Baseline visual acuity was 6/12 or better in 17.5% of the patients at presentation. This proportionincreased to 27.5%, 40%, 52.5% and 67.5% at 1, 3, 6 and 12 months respectively. Macular thickness measuredat presentation was 540 ± 120 μm. Macular thickness gradually reduced on follow-up. At one month meanmacular thickness was 430 ± 90 μm. It was less than 300 μm after 6 months.Conclusion: Intravitreal bevacizumab results in improved functional and anatomical outcomes in cases ofmacular edema secondary to BRVO.

scholarly journals Outcomes of Intravitreal Bevacizumab in Patients with Diabetic Macular Edema at a Tertiary Hospital in Northern Tanzania

2020 ◽  
pp. 27-34
Author(s):  
Shariza Kanji ◽  
Kazim Dhalla ◽  
William Makupa
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Central Vision ◽  
Macular Volume ◽  
The Mean ◽  
Anatomical Outcomes

Background: Diabetic macular edema is a type of diabetic maculopathy affecting the central vision, ranging from mild blur to blindness. Laser photocoagulation has been the mainstay of treatment for the past three decades but it has a limited role in improving the central vision. Recent introduction of anti-vascular endothelial growth factors appears to be promising in restoring vision. However, due to its short half life multiple injections are required to control edema and maintain vision. Objectives: To determine the visual and anatomical outcomes of intravitreal bevacizumab in patients with diabetic macular edema. Methods: A hospital based retrospective cross-sectional study was done at Kilimanjaro Christian Medical Center eye department from 2011- 2015. During this time, patients with  diabetic macular edema who were given intravitreal bevacizumab and satisfied the inclusion criteria were included in the study. Visual acuity, central macular thickness and macular volume were recorded at baseline, six, twelve, eighteen, twenty four and thirty weeks respectively. Optical coherence tomography was used to record central macular thickness and macular volume. Univariate and multivariate binary regression analysis were done and the p-value, odds ratio and 95% confidence interval were calculated. Results: The prevalence of Diabetic macular edema was 15.4%. Mean baseline visual acuity improved from  0.9 ± 0.57 log MAR (6/48) to 0.6±0.49 log MAR (6/24) (95% CI 0.207 - 0.389) at 30 weeks. The mean baseline central macular thickness decreased from 426.97 ± 148.358 μm to 280.98 ± 95.89  μm at 30 weeks (95% 151.531 - 187.044, P < .001). The mean baseline macular volume decreased significantly from 10.59 ± 2.55 mm3 to 8.38 ± 1.498 mm3 (95% CI 1.860 - 2.886) at 30 weeks. In multivariate analysis, patients with no hypertension were more likely to have a better visual outcome of 6/18 or better (95% CI 1.064 - 4.420, P < .033). Conclusion: This study shows a high burden of diabetic macular edema in our setting. Intravitreal bevacizumab injection results in better visual and anatomical outcomes.

scholarly journals The Effects of Intravitreal Bevacizumab in Infectious and Noninfectious Uveitic Macular Edema

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Hassan Al-Dhibi ◽  
Issam H. Hamade ◽  
Ali Al-Halafi ◽  
Maan Barry ◽  
Charbel Bou Chacra ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Case Series ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Ocular Tuberculosis ◽  
Intravitreal Bevacizumab Injection ◽  
Uveitic Macular Edema ◽  
Infectious Uveitis ◽  
The Mean

Background/Aims.To assess the effect of intravitreal bevacizumab injection (IVBI) for the treatment of macular edema due to infectious and noninfectious uveitides.Design.Retrospective interventional case series.Methods.A chart review was performed on all the patients who were diagnosed with uveitic macular edema (UME) and received 1.25 mg of IVBI at two referral centers in Riyadh, Saudi Arabia. All included patients had their visual acuity and macular thickness analyzed at baseline and at 1 and 3 months following IVBI and any sign of reactivation was noted.Results.The mean age of patients was41±16years with a mean followup of4±1months. Ten patients had idiopathic intermediate uveitis, 9 patients had Behcet’s disease, 10 had idiopathic panuveitis, and twelve patients had presumed ocular tuberculosis uveitis. Following IVBI, the mean LogMAR visual acuity improved from0.8±0.8at baseline to0.4±0.5at 1 month and0.3±0.5at 3 months (P<0.002, at 3 months). The mean macular thickness was430±132 μm at baseline. Following IVBI macular thickness improved to286±93 μm at 1 month and to265±88 μm at 3 months of followup (P<0.001, at 3 months).Conclusion.Bevacizumab was effective in the management of UME associated with both infectious and noninfectious uveitides. Intravitreal bevacizumab induced remission of UME with infectious uveitis and had no immunosuppressive effect against infectious agents.

Change in Visual Acuity in Relation to Central Macular Thickness after Intravitreal Bevacizumab in Diabetic Macular Edema

2020 ◽  
Vol 36 (3) ◽  
Author(s):  
Muhammad Ali Haider ◽  
Uzma Sattar ◽  
Syeda Rushda Zaidi
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Rank Test ◽  
P Value ◽  
Central Macular Thickness ◽  
Anti Vegf ◽  
Quasi Experimental

Purpose: To evaluate the change in visual acuity in relation to decrease in central macular thickness,after a single dose of intravitreal Bevacizumab injection.Study Design: Quasi experimental study.Place and Duration of Study: Punjab Rangers Teaching Hospital, Lahore, from January 2019 to June 2019.Material and Methods: 70 eyes with diabetic macular edema were included in the study. Patients having high refractive errors (spherical equivalent of > ± 7.5D) and visual acuity worse than +1.2 or better than +0.2 on log MAR were excluded. Central macular edema was measured in μm on OCT and visual acuity was documentedusing Log MAR chart. These values were documented before and at 01 month after injection with intravitrealBevacizumab. Wilcoxon Signed rank test was used to evaluate the difference in VA beforeand after the anti-VEGF injection. Difference in visual acuity and macular edema (central) was observed,analyzed and represented in p value. P value was considered statistically significant if it was less than 0.01%.Results: Mean age of patients was 52.61 ± 1.3. Vision improved from 0.90 ± 0.02 to 0.84 ± 0.02 on log MARchart. The change was statistically significant with p value < 0.001. Central macular thickness reduced from 328 ±14 to 283 ± 10.6 μm on OCT after intravitreal anti-VEGF, with significant p value < 0.001.Conclusion: A 45 μm reduction in central macular thickness was associated with 0.1 Log MAR unit improvementin visual acuity after intravitreal Bevacizumab in diabetic macular edema.

Comparison of the Effectiveness of Intravitreal Ranibizumab for Diabetic Macular Edema in Vitrectomized and Nonvitrectomized Eyes

2016 ◽  
Vol 236 (2) ◽  
pp. 67-73 ◽  
Author(s):  
Yoshito Koyanagi ◽  
Shigeo Yoshida ◽  
Yoshiyuki Kobayashi ◽  
Yuki Kubo ◽  
Muneo Yamaguchi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Treatment Option ◽  
Central Macular Thickness ◽  
Intravitreal Ranibizumab ◽  
Corrected Visual Acuity ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Purpose: To compare the effectiveness of intravitreal ranibizumab (IVR) for diabetic macular edema (DME) between eyes with and without previous vitrectomy. Procedures: We prospectively assessed the best-corrected visual acuity (BCVA) and central macular thickness (CMT) after IVR for 6 months. Results: There were no significant differences in the baseline BCVA and CMT between both groups. In the nonvitrectomized group (n = 15), the mean changes of BCVA and CMT from baseline to month 6 were significant (p < 0.01). In the vitrectomized group (n = 10), the improvement appeared to be slower, and the mean BCVA improvement was not significant (p = 0.5), although the mean CMT decrease was significant (p < 0.05). There were no significant differences in the mean changes of BCVA and CMT between both groups at 6 months. Conclusions: The difference in the effectiveness of IVR between both groups was not significant. IVR can be a treatment option even for vitrectomized DME eyes.

scholarly journals The effect of amblyopia on clinical outcomes of children with astigmatism

2021 ◽  
Vol 13 ◽  
pp. 251584142110408
Author(s):  
Burçin Çakır ◽  
Nilgün Özkan Aksoy ◽  
Sedat Özmen ◽  
Özlem Bursalı
Keyword(s):  
Visual Acuity ◽  
Clinical Outcomes ◽  
Medical Records ◽  
Convergence Insufficiency ◽  
Corrected Visual Acuity ◽  
Ocular Deviation ◽  
The Mean ◽  
The Difference ◽  
Best Corrected Visual Acuity

Background: Amblyopia is more common in children with high astigmatism, but factors contributing to development of amblyopia and visual outcomes are not fully understood. Objective: To evaluate the effect of amblyopia on the clinical outcomes in children with ⩾1.75 diopter (D) astigmatism. Methods: We reviewed the medical records of children with ⩾1.75 D astigmatism with and without amblyopia (amblyopes group and non-amblyopes group). The mean age, gender, amount and type of ocular deviation, presence of convergence insufficiency (CI), stereopsis, time of initial spectacle use and follow-up time, differences in best-corrected visual acuity (VoD) and spherical equivalent (SE) between eyes were assessed and compared between the groups. Best-corrected visual acuity (BCVA), mean SE, astigmatism measurements were assessed and compared between amblyopic, fellow, and non-amblyopic eyes. Results: The records included 68 eyes of 34 children with amblyopia and 56 eyes of 28 children without amblyopia. The mean age, gender, amount and type of ocular deviation, presence of CI, stereopsis, time of initial spectacle use, follow-up time, and the difference in SE did not differ between groups. In amblyopes, exodeviation was more common and statistically greater in near (33 cm) than at distance (6 m) (p = 0.005). The mean BCVA and astigmatism values were statistically different between amblyopic, fellow, and non-amblyopic eyes. Conclusion: A greater near than distance exodeviation and higher mean astigmatism value were found in amblyopic children with astigmatism.

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