EFFECTS OF UNILATERAL INTRAVITREAL BEVACIZUMAB ON THE CONTRALATERAL EYE HAVING DIABETIC MACULAR EDEMA

Objective: To investigate the effect of unilateral intravitreal Bevacizumab on contralateral eye in bilateral diabetic macular edema. Study Design: Quasi-experimental study. Place and Duration of Study: Retina Department of Al-Shifa Trust Eye Hospital, Rawalpindi, from Sep to Dec 2020. Methodology: Thirty-two patients were enrolled with consecutive sampling. All the patients had clinically diagnosed diabetic macular edema having >275µm macular thickness on OCT. They were injected with 1.25mg/0.05mL of Bevacizumab in one eye. Baseline macular thickness was compared with 4 weeks follow up macular thickness, using Optical Coherence Tomography. Results: The central macular thickness in the untreated eye at baseline was 396.97 ± 29.79 µm and 388.34 ± 30.06 µm at 4 weeks (p-value=0.001). The difference in central macular thickness in treated and untreated eyes were 28.44 ± 4.11 µm and 19.81 ± 5.31 µm respectively (p-value = 0.001). There were statistically significant differences between these measurements. Conclusion: Injecting Bevacizumab in one eye for diabetic macular edema has statistically significant effect on the contralateral non-injected eye macular thickness.

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

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v36i3.1051 ◽

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.

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Aflibercept or ranibizumab for the treatment of diabetic macular edema; a retrospective study

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v10i4.1586 ◽

2019 ◽

Vol 10 (4) ◽

pp. 3000-3005

Author(s):

Khlood M. Aldossary ◽

Anfal Alruzuq ◽

Ghady Almohanna ◽

Hessa Almusallam ◽

Sara Alamri ◽

...

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Macular Thickness ◽

P Value ◽

Central Macular Thickness ◽

Intravitreal Ranibizumab ◽

Injectable Drugs ◽

Significant Difference ◽

Intravitreal Aflibercept

Diabetic macular edema (DME) is a significant cause of diabetic retinopathy and a major cause of vision loss. In this study, we aimed to evaluate and compare the efficacy of two injectable drugs; intravitreal Aflibercept and intravitreal Ranibizumab for the treatment of DME of the eyes. A retrospective chart review was conducted for patients diagnosed with DME from March 2014 to January 2019 who received either intravitreal Aflibercept or intravitreal Ranibizumab injection. A total of 57 eyes were included, of which 19 eyes were treated with intravitreal Ranibizumab injection, and 38 eyes were treated with intravitreal Aflibercept injection; all eyes were examined for 3 months. Two outcomes were assessed in this study, namely; visual acuity (VA) and central macular thickness (CMT). The mean age in the Ranibizumab group was 61.1±9.5 vs 64.3±10.2 in the Aflibercept group with no significant difference (p-value=0.25). The ratio of improvement in visual acuity (VA) in the Ranibizumab group was 68.4% vs 44.7% in the Aflibercept group; (p-value=0.038) which demonstrates the superiority of Ranibizumab over Aflibercept concerning visual acuity result. However, there is no statistically significant difference between the ratio of improvement in central macular thickness (CMT) results in both groups; (p-value=1.00). In fact, the ratio of improvement in CMT in both groups was the same 78.9% for both the groups. The pre and post results demonstrated improvement in post-procedural for CMT among both the groups but only Ranibizumab group showed VA improvement post-procedural. Through this study, we concluded that both injectable drugs improve visual acuity (VA) and decrease central macular thickness (CMT) in eyes with DME. However, Ranibizumab is superior in improving visual acuity compared to Aflibercept. Further comparative effectiveness trials between Aflibercept and Ranibizumab are still warranted.

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

Ophthalmology Research An International Journal ◽

10.9734/or/2020/v12i430153 ◽

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.

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

Jurnal Kesehatan Andalas ◽

10.25077/jka.v8i4.1094 ◽

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.

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

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v12i2.28959 ◽

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.

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CHANGES IN CENTRAL CHOROIDAL THICKNESS AFTER TREATMENT OF DIABETIC MACULAR EDEMA WITH INTRAVITREAL BEVACIZUMAB CORRELATION WITH CENTRAL MACULAR THICKNESS AND BEST-CORRECTED VISUAL ACUITY

Retina ◽

10.1097/iae.0000000000001645 ◽

2018 ◽

Vol 38 (5) ◽

pp. 970-975 ◽

Cited By ~ 10

Author(s):

Ramin Nourinia ◽

Hamid Ahmadieh ◽

Elnaz Nekoei ◽

Parviz Malekifar ◽

Zahra Tofighi

Keyword(s):

Visual Acuity ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Choroidal Thickness ◽

Intravitreal Bevacizumab ◽

Macular Thickness ◽

Central Macular Thickness ◽

Corrected Visual Acuity ◽

Best Corrected Visual Acuity

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Intravitreal Bevacizumab In Diabetic Macular Edema At RSUP Cipto Mangunkusumo in 2017

International Journal of Retina ◽

10.35479/ijretina.2019.vol002.iss002.70 ◽

2019 ◽

Vol 2 (2) ◽

Author(s):

Andi Arus Victor ◽

Masniah Masniah ◽

Ari Djatikusumo ◽

Elvioza Elvioza ◽

Gitalisa Andayani Adriono ◽

...

Keyword(s):

Visual Acuity ◽

Diabetic Retinopathy ◽

Macular Edema ◽

Diabetic Macular Edema ◽

Vision Loss ◽

Intravitreal Bevacizumab ◽

Macular Thickness ◽

Central Macular Thickness ◽

The Third ◽

Department Of Ophthalmology

Introduction: Diabetic Macular Edema (DME) is a manifestation of diabetic retinopathy and is the most common cause of vision loss in diabetics. The incidence of DME has a tendency to increase, concomitant with the prevalence of diabetes globally by more than 50% from 2000 to 2030. This study aims to evaluate the proportion of central macular thickness (CMT) improvement and visual acuity in DME patients treated with intravitreal bevacizumab (IVB) injection. Methods: This study is a retrospective descriptive study. The study was conducted in the Department of Ophthalmology at RSUP Cipto Mangunkusumo (RSCM) Jakarta. Data were obtained from the medical records of all diabetic retinopathy patients with macular edema who were treated with IVB at RSCM Kirana Vitreoretina Polyclinic on January – December 2017. Results: Of the 44 subjects, improvement in best corrected visual acuity (BCVA) occurred in 24 (54.54%) subjects at the first-month evaluation and 19 (43.18%) subjects at the third-month evaluation. CMT decreased in 37 (84.41%) subjects at the first-month evaluation and 35 (81.81%) subjects at the third-month evaluation. Conclusion: Visual acuity improvement and central macular thickness reduction 3 months after IVB injection. These results strengthen IVB injection to be an alternative to adjuvant therapy in DME. Keywords: Diabetic Macular Edema, Intravitreal Bevacizumab Injection

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

Ophthalmologica ◽

10.1159/000446992 ◽

2016 ◽

Vol 236 (2) ◽

pp. 67-73 ◽

Cited By ~ 5

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.

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