scholarly journals Anatomical and visual outcome of intravitreal bevacizumab (Avastin) in patients with diabetic macular edema

2016 ◽  
Vol 8 (1) ◽  
pp. 54-61
Author(s):  
Shyam Vyas ◽  
Raba Thapa ◽  
Sanyam Bajimaya ◽  
Eli Pradhan ◽  
Govinda Paudyal
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Intravitreal Bevacizumab ◽  
Visual Outcome ◽  
Central Retinal Thickness ◽  
Post Injection ◽  
Macular Volume

Background: Intravitreal bevacizumab has been shown to be an effective treatment of diabetic macular edema. Objective: To assess the anatomical and visual outcome of intravitrealbevacizumab (Avastin) in patients of diabetic macular edema. Materials and methods: 52 eyes of 33 patients with diabetic retinopathy with CSME were included in this study. Detailed ophthalmic examination, including best-corrected visual acuity(BCVA), stereoscopic biomicroscopy, and retinal thickness measurement by Optical coherence tomography (OCT), was done at baseline and at each follow- up visit. All patients were treated with 0.05 mL intravitreal injection containing 1.25 mg of bevacizumab and repeat injection was given in cases of recurrent/persistent subretinal or intraretinal fluid shown by OCT and deterioration of BCVA. Results: All patients completed 6 months of follow-up with mean number of 2.78 intravitreal injections per eye.The mean BCVA at baseline was 0.80 log MAR, with significant changes 0.68 (p=0.012), 0.63 (p=<0.001) and 0.60 log MAR (p=<0.001) at 6 weeks, 3 months, and 6 months respectively. Final BCVA analysis demonstrated that 25 eyes (48.07%) remained stable and 22 (42.30%) improved ≥2 lines on BCVA. The mean central retinal thickness was 449.03 μm at baseline and it decreased significantly to 410.09 (p<0.001),345.76(p<0.001), 344.55(p<0.001) and 326.51(p<0.001) at 1st day, 6 weeks, 3 months and 6 months post injection, respectively. Mean macular volume changed significantly from baseline of 10.77 μm to 10.33μm (p<0.001) 8.97 (p<0.001), 8.82 (p<0.001), 8.95 (p<0.001) at 1st day, 6 weeks, 3 months and 6 months post injection respectively. Conclusion: Intravitreal bevacizumab injection resulted in significant improvement in BCVA, central retinal thickness and total macular volume in patients with diabetic retinopathy with CSME, and this beneficial effect is maximum at 6 weeks. Also, slight reduction in these parameters at 3 month follow up suggests that visual improvement and stable macular thickness can be maintained longer with injection frequency of probably 6-12 weeks. Nepal J Ophthalmol 2016; 8(15): 54-61

scholarly journals Switch to Aflibercept in Diabetic Macular Edema Patients Unresponsive to Previous Anti-VEGF Therapy

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Filipe Mira ◽  
Manuel Paulo ◽  
Filipe Henriques ◽  
João Figueira
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retrospective Review ◽  
Retinal Thickness ◽  
Central Retinal Thickness ◽  
Functional Improvement ◽  
Anti Vegf ◽  
The Mean

Purpose. The aim was to evaluate the efficacy of aflibercept in patients with diabetic macular edema (DME) unresponsive to prior anti-VEGF therapy. Methods. Retrospective review of DME unresponsive to previous anti-VEGF switched to aflibercept with 3 months of follow-up. Changes in best correct visual acuity (BCVA), central retinal thickness (CRT), and frequency of injections were analyzed. The percentage of subjects who had ≥20/40 (logMAR equivalent 0.3) and ≤20/200 (logMAR equivalent 1) was evaluated. Results. A total of 32 eyes from 26 patients were included. Mean age was 65 ± 10 years old. The mean number of previous anti-VEGF injections was 5.34 ± 2.38, and the mean number of aflibercept injections at the end of the study was 2.00 ± 0.00. The CRT at baseline was 501.47 ± 150.51 μm and 367.97 ± 124.61 μm at 3 months of follow-up (P<0.001). The logMAR BCVA at baseline was 0.71 ± 0.36 and 0.65 ± 0.33 at the end of the follow-up (P=0.037). At baseline, 12.5% of patients had ≥20/40 compared with 25% at the end of follow-up. At baseline, 28.13% of patients had 20/200 or inferior vision compared with 15.63% at the end of the follow-up. Conclusions. DME patients unresponsive to previous multiple ranibizumab injections demonstrate a significant anatomical and functional improvement with the switch to aflibercept.

Diabetic macular edema treated with ranibizumab following bevacizumab failure in Israel (DERBI study)

2018 ◽  
Vol 29 (2) ◽  
pp. 229-233 ◽  
Author(s):  
Rita Ehrlich ◽  
Russell Pokroy ◽  
Ori Segal ◽  
Michaella Goldstein ◽  
Ayala Pollack ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Intravitreal Bevacizumab ◽  
Visual Outcome ◽  
Initial Therapy ◽  
Interquartile Range ◽  
Intravitreal Ranibizumab ◽  
Persistent Diabetic Macular Edema ◽  
Ranibizumab Treatment

Purpose: To evaluate the outcome of second-line intravitreal ranibizumab treatment in eyes with diabetic macular edema having persistent edema following initial therapy with intravitreal bevacizumab. Methods: Diabetic macular edema treated with ranibizumab following bevacizumab failure in Israel was a retrospective, multi-center study. Consecutive eyes with persistent diabetic macular edema following at least three previous intravitreal bevacizumab injections prior to intravitreal ranibizumab, at least three-monthly intravitreal ranibizumab injections and at least 12 months of follow-up were included. Data collected included demographics, ocular findings, diabetes control, details of intravitreal bevacizumab and ranibizumab injections, and visual and anatomical measurements before and after intravitreal ranibizumab treatment. Results: In total, 202 eyes of 162 patients treated at 11 medical centers across Israel were included. Patients received a mean (±standard deviation) of 8.8 ± 4.9 intravitreal bevacizumab injections prior to the switch to intravitreal ranibizumab. A mean of 7.0 ± 2.7 intravitreal ranibizumab injections were given during the 12 months following the switch to intravitreal ranibizumab. The median central subfield retinal thickness (±interquartile range) by spectral-domain optical coherence tomography decreased from 436 ± 162 µm at baseline to 319 ± 113 µm at month 12 (p < 0.001). Median logMAR visual acuity (±interquartile range) improved from 0.40 ± 0.48 at baseline to 0.38 ± 0.40 at month 12 (p = 0.001). Linear regression suggested that higher number of intravitreal ranibizumab injections and higher pre-switch central subfield retinal thickness were associated with favorable visual outcome. Higher number of intravitreal bevacizumab injections and the presence of intraretinal fluid before the switch lessened the odds of favorable outcome. Conclusion: Switching from bevacizumab to ranibizumab in persistent diabetic macular edema was associated with anatomical improvement in the majority of eyes and ⩾2 lines of vision improvement in 22% of eyes.

scholarly journals A study of therapeutic effects of 670 nm irradiation in different types of diabetic macular edema

2021 ◽  
Vol 9 (4) ◽  
pp. 15-22
Author(s):  
S. Ramin ◽  
M. Ahadi ◽  
A. Ebrahimi
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Central Retinal Thickness ◽  
Diabetic Patients ◽  
Therapeutic Effects ◽  
Positive Effects ◽  
The Mean

The purpose of this study was to investigate the therapeutic effects of 670 nm irradiation in patients with diabetic macular edema. In several studies, positive effects of red/near-infrared irradiation showed in a range of ocular diseases such as macular degeneration, macular edema, and retinitis pigmentosa. This study was conducted on forty five eyes of 26 diabetic patients with macular edema between the ages of 51 and 80.Measurement of visual acuity and slit lamp examination, funduscopy, and optical coherence tomography were performed in all subjects. None of the patients had proliferative retinopathy. We used a portable LED device (Warp 10, Quantum Devices) for treatment. Patients held this device at a distance of 3 cm from their eyes for 240 seconds for three months. Full ophthalmic examinations were repeated 1, 2, and 3 months after treatment.After 3 months, the mean visual acuity improved from 0.44 ± 0.38 log MAR to 0.27 ± 0.24 log MAR and vision increased by 1.52 ± 1.16 lines post treatment (р<0.001). The mean central macula thickness decreased from 381.49 ± 144.40 μm to 359.72 ± 128.84 μm (р=0.050). In patients with mild and moderate nonproliferative diabetic retinopathy, the mean central retinal thickness decreased 52.06 ± 67.78 μm and 39.27 ± 44.69 μm, respectively, but patients with severe type showed an increase of 34.93 ± 65.65 μm in the mean central retinal thickness (р<0.001). Also, the severity of macular edema had no effect on final outcomes (р>0.05). Photobiomodulation can positively affect diabetic macular edema, especially in patients with mild to moderate diabetic retinopathy.

Correlation of response to intravitreal bevacizumab treatment between the first and second treated eyes in diabetic macular edema

2021 ◽  
pp. 112067212110596
Author(s):  
Nadav Levinger ◽  
Liran Tiosano ◽  
Elishai Assayag ◽  
Rivkah Lender ◽  
Tomer Batash ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Thickness Reduction ◽  
Bevacizumab Treatment ◽  
Central Subfield Thickness ◽  
Bilateral Diabetic Macular Edema ◽  
The Mean ◽  
Selection Of

Purpose To evaluate whether outcome of bevacizumab treatment in the first treated eye can guide the selection of compound for the second treated eye in patients with bilateral diabetic macular edema. Methods Demographic, clinical, and optical coherence tomography data were retrospectively collected from consecutive patients who underwent bevacizumab therapy for bilateral diabetic macular edema. Change in central subfield thickness and visual acuity were evaluated and compared between the first treated eye and second treated eye. Results A total of 66 eyes of 33 patients were included in the study. The mean ± SD follow-up time was 13 ± 5 months. The mean ± SD central subfield thickness at baseline was 464 ± 30 μm in the first treated eye and 461 ± 29 μm in the second treated eye ( p = 0.91). Final central subfield thickness was reduced to 392 ± 27 μm in the first treated eye ( p = 0.01 compared with baseline) and 416 ± 25 μm in the second treated eye ( p = 0.03 compared with baseline). Using ≥5% or ≥10% reduction of central subfield thickness as diagnostic criteria to predict similar magnitude of thickness reduction in the first treated eye yielded a positive and negative predictive value ranging from 46% to 81%, and sensitivity and specificity ranging from 54% to 84%. Regression models did not show correlation between central subfield thickness reduction in first treated eye and the second treated eye at the end of follow-up. Conclusions Bevacizumab therapy reduced macular thickness in both eyes in bilateral diabetic macular edema. Treatment outcome of the first treated eye could not predict the outcome of the second treated eye. Particularly, failure to reduce central subfield thickness in the first treated eye does not preclude a favorable response to bevacizumab therapy in the second eye.

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 Comparison of the Efficacy and Safety of Intravitreal Conbercept with Intravitreal Ranibizumab for Treatment of Diabetic Macular Edema: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Xiaolei Sun ◽  
Jingjing Zhang ◽  
Jingyi Tian ◽  
Shijiu Chen ◽  
Fanxing Zeng ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Pooled Analysis ◽  
Central Retinal Thickness ◽  
Cochrane Library ◽  
Intravitreal Ranibizumab ◽  
Significant Difference

Introduction. This meta-analysis aimed to compare the therapeutic effect and safety of intravitreal conbercept (IVC) versus intravitreal ranibizumab (IVR) in treatment of diabetic macular edema (DME). Methods. Relevant studies were identified through systemic searches of PubMed, Embase, Cochrane Library, Ovid, CNKI, and Wanfang database up to 28 February 2019. Changes in central retinal thickness (CRT) in μm and best-corrected visual acuity (BCVA) in logMAR equivalents at 1, 3, and 6 months after initial treatment were performed by pooled analysis. Adverse events (AEs) were evaluated. Results. Eight articles involving 588 patients with DME were identified for this meta-analysis. The results showed that IVC significantly improved BCVA compared with IVR at 6 mo (SMD = −0.74 95% CI: −1.28 to −0.2; p=0.029) in patients with DME. IVC was superior to IVR in reducing central retinal thickness (CRT at 1 mo (p<0.0001), 3 mo (p=0.025), and 6 mo (p=0.019)) from baseline with statistical significance. For AEs, the pooled results showed that no significant difference in the risk of intraocular pressure increased (OR = 1.71; 95% CI: 0.55 to 5.25; p=0.352) or conjunctival hemorrhage (OR = 0.89; 95% CI: 0.34 to 2.34; p=0.65) between two groups. Conclusions. This meta-analysis showed that IVC trended to be more effective than IVR in terms of functional and anatomic outcomes for treating DME.

Minimally Invasive Microincision Vitrectomy Surgery with an Intraoperative Dexamethasone Implant for Refractory Diabetic Macular Edema

2016 ◽  
Vol 235 (3) ◽  
pp. 150-156 ◽  
Author(s):  
Dong Hoon Lee ◽  
Yoon Jeon Kim ◽  
Young Hee Yoon
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Safe Alternative ◽  
Corrected Visual Acuity ◽  
Refractory Diabetic Macular Edema ◽  
History Of ◽  
Microincision Vitrectomy Surgery ◽  
Vitrectomy Surgery

Purpose: To evaluate the 1-year results of 25-gauge microincision vitrectomy surgery (MIVS25) combined with intraoperative dexamethasone (DEX) implant for persistent diabetic macular edema (DME). Methods: This study enrolled patients who had a history of DME for ≥12 months and underwent MIVS25 and DEX implant injection. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were assessed postoperatively. Results: Eighteen eyes were included in the analysis. Preoperatively, logMAR BCVA was 0.90 and CRT was 594 µm on average. CRT decreased until the 3-month follow-up visit and tended to increase at 6 months, but stabilized at 12 months with additional treatments in five eyes at 5 months postoperatively. Statistically significant improvement in BCVA was noted 1 month after treatment and at each subsequent follow-up visit (p < 0.001). Conclusion: MIVS25 combined with DEX implant injection might be utilized as an effective and safe alternative treatment for intractable DME.

Sign in / Sign up

Export Citation Format

Share Document