Acute Visual Acuity Loss Following Intravitreal Bevacizumab for Diabetic Macular Edema

2009 ◽  
Vol 40 (1) ◽  
pp. 68-70 ◽  
Author(s):  
Eric Chen ◽  
Jason Hsu ◽  
Carl H. Park
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Visual Acuity Loss

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.

scholarly journals Intravitreal bevacizumab injection alone or combined with macular photocoagulation compared to macular photocoagulation as primary treatment of diabetic macular edema

2015 ◽  
Vol 72 (10) ◽  
pp. 876-882 ◽  
Author(s):  
Sandra Jovanovic ◽  
Vladimir Canadanovic ◽  
Ana Sabo ◽  
Zorka Grgic ◽  
Milena Mitrovic ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Laser Treatment ◽  
Diabetic Macular Edema ◽  
Combined Treatment ◽  
Intravitreal Bevacizumab ◽  
Primary Treatment ◽  
Intravitreal Bevacizumab Injection ◽  
Vegf Inhibitor ◽  
The Mean

Background/Aim. Within diabetic retinopathy (DR), diabetic macular edema (DME) is one of the leading causes of the loss of visual acuity. The aim of this study was to determine the efficacy of the intravitreal vascular endothelial growth factor (VEGF) inhibitor application alone or combined with macular focal/grid lasephotocoagulation compared with laser treatment alone. Methods. This prospective randomized clinical trial included 72 patients (120 treated eyes) with varying degrees of DR and DME. The DME treatment included intravitreal VEGF inhibitor bevacizumab (Avastin?) application, with and without laser treatment. Bevacizumab (1.25 mg/0.05 mL) was administered intravitreally in 4-6-week intervals. Laser is applied 4-6 weeks after last dose of the drug as a part of combined treatment, or as the primary treatment. Results. The mean reduction in central macular thickness (CMT) for the eyes (n = 31) treated with bevacizumab alone was 162.23 ?m, for the eyes (n = 53) treated with combined treatment the mean reduction in CMT was 124.24 ?m, both statistically significant at p < 0.001. Laser macular photocolagulation as a part of combined treatment (in 53 eyes) significantly contributed to the CMT reduction, based on the paired t-test results (366.28 vs 323.0 ?m at p < 0.05). In our study, the mean visual acuity improvement of 0.161 logMAR was achieved in the group of eyes treated with bevacizumab alone, and 0.093 logMAR in the group with combined treatment, both statistically significant at p < 0.05. The effect of laser photocolagulation alone on visual acuity and CMT was not statistically significant. Conclusion. Treatment with bevacizumab alone or within combined treatment is more effective in treating DME than conventional macular laser treatment alone, both anatomically and functionally.

Aflibercept: A Review of Its Use in the Management of Diabetic Eye Complications

2016 ◽  
Vol 30 (5) ◽  
pp. 534-540 ◽  
Author(s):  
Oluwaranti Akiyode ◽  
Jateh Major ◽  
Abiola Ojo
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vascular Endothelial ◽  
Efficacy And Safety ◽  
Vegf Inhibitor ◽  
Anti Vegf ◽  
Visual Acuity Loss ◽  
Endothelial Growth Factor

Aflibercept is the most recently approved vascular endothelial growth factor (anti-VEGF) inhibitor for the management of diabetic macular edema and diabetic retinopathy. The purpose of this article is to review the efficacy and safety of aflibercept in the management of diabetic eye complications and to describe its place in therapy. Anti-VEGF agents have been noted in clinical trials to be superior to laser photocoagulation, the standard therapy ( P < .0001, P ≤ .0085, respectively). Aflibercept has been comparatively studied with other anti-VEGF agents, namely, bevacizumab and ranibizumab, and noted to be equally efficacious and safe in patients with mild visual acuity loss ( P > .50). However, in the treatment of patients with diabetic macular edema having moderate to severe visual acuity loss, aflibercept outperformed the other 2 anti-VEGF agents (aflibercept vs bevacizumab, P < .001; aflibercept vs ranibizumab, P = .003). However, additional studies are needed to fully appreciate the long-term safety and efficacy of aflibercept and the anti-VEGF therapy class.

scholarly journals Costs and Quality of Life in Diabetic Macular Edema: Canadian Burden of Diabetic Macular Edema Observational Study (C-REALITY)

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
John R. Gonder ◽  
Valery M. Walker ◽  
Martin Barbeau ◽  
Nancy Zaour ◽  
Bryan H. Zachau ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Severe Loss ◽  
Telephone Interviews ◽  
Related Quality ◽  
Visual Acuity Loss ◽  
Composite Scores

Purpose. To characterize the economic and quality of life burden of diabetic macular edema (DME) in Canadian patients.Patients and Methods. 145 patients with DME were followed for 6 months with monthly telephone interviews and medical chart reviews at months 0, 3, and 6. Visual acuity in the worst-seeing eye was assessed at months 0 and 6. DME-related healthcare costs were determined over 6 months, and vision-related (National Eye Institute Visual Functioning Questionnaire) and generic (EQ-5D) quality of life was assessed at months 0, 3, and 6.Results. Mean age of patients was 63.7 years: 52% were male and 72% had bilateral DME. At baseline, visual acuity was categorized as normal/mild loss for 63.4% of patients, moderate loss for 10.4%, and severe loss/nearly blind for 26.2%. Mean 6-month DME-related costs/patient were as follows: all patients (n=135), $2,092; normal/mild loss (n=88), $1,776; moderate loss (n=13), $1,845; and severe loss/nearly blind (n=34), $3,007. Composite scores for vision-related quality of life declined with increasing visual acuity loss; generic quality of life scores were highest for moderate loss and lowest for severe loss/nearly blind.Conclusions. DME-related costs in the Canadian healthcare system are substantial. Costs increased and vision-related quality of life declined with increasing visual acuity severity.

scholarly journals Alone laser versus bevacizumab plus laser for diffuse diabetic macular edema (ALBA randomized trial)

2021 ◽  
Vol 13 ◽  
pp. 251584142098821
Author(s):  
Alicia Pareja-Ríos ◽  
Elena de Armas-Ramos ◽  
Ana Aldea-Perona ◽  
Sergio Bonaque-González
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Laser Treatment ◽  
Diabetic Macular Edema ◽  
Controlled Trial ◽  
Intravitreal Bevacizumab ◽  
Clinical Trial Registry ◽  
Diffuse Diabetic Macular Edema ◽  
Related Quality ◽  
Health Related

Purpose: To report the 12-month results of laser (treatment G1) versus intravitreal bevacizumab combined with laser (treatment G2) in patients with diffuse diabetic macular edema (DME). Methods: In this single-center randomized independent controlled trial, 32 patients were randomized to G1 ( n = 15) or G2 ( n = 17). In G1, laser was given at baseline and then pro re nata (PRN). In G2, three intravitreal bevacizumab (1.25 mg) injections were given once every 6 weeks, then laser and then PRN. Analysis was performed by treatment as administered. This study was registered in clinicaltrials.gov as NCT01572350 and EU Clinical Trial Registry as 2009-014654-15. Results: G2 was superior to G1 improving best corrected visual acuity (BCVA) with respect baseline (+8.0 vs + 3.0; p < 0.01). At month 12, a significantly greater proportion of patients had a BCVA letter score >15 and >73 in G2 (3 of 15 (20%) and 8 of 15 (53%), respectively) versus G1 (1 of 17 (6%) and 4 of 18 (23%), respectively). Health-related quality of life, assessed through National Eye Institute Visual Function Questionnaire, at 12 months was statistically indistinguishable between both groups. Conclusion: G2 provided superior visual acuity gains over G1 in patients with visual impairment due to center-involving diffuse DME, associated with significant gains in VFQ-25 scores.

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 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 Pengaruh Bevacizumab Intravitreal terhadap Best Corrected Visual Acuity dan Central Macular Thickness pada Diabetic Macular Edema

2020 ◽  
Vol 8 (4) ◽  
Author(s):  
Arini Ghaisa Atsari ◽  
Weni Helvinda
Keyword(s):  
Visual Acuity ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
Central Macular Thickness ◽  
Corrected Visual Acuity ◽  
Anti Vegf ◽  
One Way Anova ◽  
Best Corrected Visual Acuity

Diabetic Macular Edema (DME) adalah penyebab utama kebutaan pada populasi diabetes. Salah satu patogenesis pada DME adalah karena peningkatan ekspresi VEGF. Bevacizumab adalah anti-VEGF yang dapat meningkatkan Best Corrected Visual Acuity (BCVA) dan mengurangi Central Macular Thickness (CMT) pada pasien DME. Tujuan: Mengetahui persentase jenis kelamin, usia, durasi DM tipe II, BCVA dan CMT sebelum dan setelah injeksi pada bulan pertama dan bulan ketiga pada pasien DME serta menganalisis pengaruh intravitreal bevacizumab anti-VEGF terhadap BCVA dan CMT pada DME di Rumah Sakit M Djamil Padang. Metode: Penelitian ini adalah studi retrospektif analitik berdasarkan rekam medis dari 16 pasien DME yang telah injeksi bevacizumab intravitreal pada tahun 2017. Data dianalisis secara statistik menggunakan uji one way Anova dengan p < 0,05 dianggap signifikan. Hasil: Pasien terdiri dari 11 wanita (68,8%) dan 5 pria (31,2%). Jumlah usia pasien terbanyak antara 51-55 tahun (43,8%) dan durasi terlama yang diketahui DM tipe II adalah 5-10 tahun (50,0%). Rata-rata BCVA (logMAR) sebelum injeksi intravitreal bevacizumab adalah 0,95, bulan pertama setelah injeksi adalah 0,68, dan bulan ketiga setelah injeksi adalah 0,55. CMT rata-rata sebelum injeksi bevacizumab intravitreal adalah 427,62, bulan pertama setelah injeksi 359,59, dan bulan ketiga setelah injeksi 318,12. Simpulan: Terdapat pengaruh bevacizumab anti-VEGF intravitreal terhadap BCVA dan CMT di DME di Rumah Sakit M Djamil Padang.

scholarly journals Evaluation of the Effect of Intravitreal Bevacizumab (Avastin) in Patients with Diabetic Macular Edema

2020 ◽  
Vol 12 (2) ◽  
pp. 236-244
Author(s):  
Pawan Mahat ◽  
Purushottam Joshi ◽  
Eli Pradhan ◽  
Prabha Subedi
Keyword(s):  
Diabetes Mellitus ◽  
Visual Acuity ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Diabetic Macular Edema ◽  
San Francisco ◽  
Retinal Thickness ◽  
Intravitreal Bevacizumab ◽  
Macular Thickness ◽  
P Value

Introduction: Diabetic macular edema (DME) is the leading cause of visual impairment in patients with diabetes mellitus. The objectives of the study was to figure out the effect of intravitreal injection bevacizumab on visual acuity and retinal thickness in people with DME. Materials and methods: We observed the case records of patients with DME requiring injection Avastin (Genentech Inc., San Francisco, CA, USA) intravitreal from January to July 2016 in Mechi Eye Hospital. The eighty seven eyes of 60 patients with DME were included in the study. Inclusion criteria were determined independently of the age, metabolic control, type of diabetes mellitus, visual acuity, leakage area size,retinal thickness as measured by optical coherence tomography. All the patients were treated with 0.05 ml injection containing 1.25 mg of Avastin (Genentech Inc., San Francisco, CA, USA) after written informed consent. Results: The mean age group was 55.86 ± 9.61 years with 47 males and 13 females. At baseline the median BCVA was 1.00 (0.60-1.30) which improved to 0.78 (0.48- 1.00) at 6 weeks (p=0.001) which further improved to 0.78 (0.48-1.00) Log MAR (p value- 0.005) at 12 weeks and 0.60 (0.43- 1.00) Log MAR at 18 weeks (p value= 0.006). Baseline mean central macular thickness (CMT) on OCT was 436.24 ± 142.2μm which decreased to 387.74±130.98μm at 6 weeks, 346.82 ±116.79 μm at 12 weeks and 307.1 ±105.49μm. Changes in VA and decrease in central subfield macular thickness during follow up visit was statistically significant (p<0.05). Conclusion: In this study, intravitreal injection Avastin resulted in improvement in VA and decrease in retinal thickness in patients with DME.

Subthreshold Laser and Subliminal (Micropulse) Laser in Diabetic Retinopathy and Diabetic Macular Edema

2018 ◽  
pp. 177-184
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Collateral Damage ◽  
Micropulse Laser ◽  
Working Age ◽  
Visual Acuity Loss ◽  
Subthreshold Laser ◽  
Conventional Laser

Diabetic macular edema (DME) is one of the main causes of a significant reduction in visual acuity in working-age adults and is the most common cause of visual acuity loss from diabetic retinopathy. Most of the studies have shown that the ability of the conventional laser to maintain or improve visual acuity is limited, possibly because of the development of retinal scars, which decrease the potential for improved visual acuity. Subthreshold laser and subliminal (micropulse) laser has the potential to reduce DME with better visual acuity results compared with conventional laser, as it does not cause collateral damage in the retina. These lasers cannot cause permanent damage to the retina. This article mentions subthreshold laser, and subliminal (micropulse) laser in diabetic retinopathy and diabetic macular edema.

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