Abstract

SO.11.02

Long-term follow-up after intravitreal therapy with bevacizumab for treatment of persistent diffuse diabetic macular edema

Kook D., Wolf A., Strauss R., Neubauer A. S., Ulbig M. W., Kampik A., Haritoglou C.
Department of Ophthalmology, Ludwig-Maximilians-University, Munich

Objective: To evaluate the long-term efficacy of intravitreal bevacizumab for the treatment of persistent diffuse diabetic macular edema.
Methods: 54 patients with chronic diffuse diabetic macular edema were consecutively incorporated in a prospective, non-comparative case series. Inclusion was performed independently from the size of edema, retinal thickness, visual acuity (VA), age, metabolic control, type of diabetes or previous treatments. The patients underwent a complete eye examination including best-corrected VA determination with ETDRS-standard charts, slit lamp examination, intraocular pressure measurement, stereoscopic biomicroscopy of the macula, retinal thickness measurement using OCT, fluorescein angiography and fundus photography. All patients were treated with repeated intravitreal injections of bevacizumab (1.25 mg). Patients were followed-up every 4-12 weeks for a period of at least 12 months.
Results: All patients had received previous treatments such as laser therapy, vitrectomy or intravitreal injection of triamcinolone. All patients completed 12 months follow-up, within this period 68% had received at least three intravitreal injections. At baseline mean VA was 50.5 ETDRS-letters and mean central retinal thickness on OCT was 452 µm. VA changes were not significant throughout follow-up (mean VA was 49.4 ETDRS-letters after 12 months). Mean central retinal thickness decreased to 393 µm after 12 months.
Conclusions: Even in cases of diffuse diabetic macular edema that have not responded to previous treatments, a decrease of central retinal thickness can be observed following repeated intravitreal injections of bevacizumab. However, this decrease in retinal thickness is not associated with gain in VA.

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