Intravitreal Bevacizumab (Avastin) for Primary Treatment of Diffuse Diabetic Macular Oedema

Abstract

Objective: To evaluate the effect of intravitreal Bevacizumab injection on visual acuity in diffuse
diabetic macular oedema.
Material & Methods: 25 eyes of 25 diabetic patients were treated with 1.5 mg/0.1 ml of
intravitreal bevacizumab injection as the primary therapy for diffuse diabetic macular oedema.
This prospective study was conducted in Eye Unit I, SIMS/Services Hospital, Lahore over 6
months from November 2008 to April 2009. 17 patients were male and 08 were female, age
ranged between 35 to 52 years. All patients were completely evaluated in out patient department
of Eye Unit - I. Every patient underwent complete ophthalmological evaluation including history,
record of visual acuity and IOP, slit lamp bi-microscopic examination, fundi assessment with 78
lens and indirect ophthalmoscope. Fundus fluorescein angiogram was done to exclude macular
ischaemia and optical coherence tomography was done to evaluate the macular oedema.
Intravitreal Avastin 1.5 mg/ 0.1 ml injection was given to these patients under complete aseptic
techniques in operation theater after explaining the advantages and disadvantages of the
intravitreal injection to the patients.
Results: Visual Acuity increased in 25 eyes during follow up time of six month; the mean best
corrected log MAR value of visual acuities of the patients before intravitreal bevacizumab
injection was 0.275 and it improved to 0.642 after intravitreal Bevacizumab injection. Diffuse
macular oedema remarkably settled in these eyes. Intravitreal injection of Avastin was repeated
in 10 patients; only one patient developed acute endophthalmitis which was treated with
intravitreal antibiotic and pars plana vitrectomy with lensectomy.
Conclusion: Intravitreal bevacizumab injection provides significant improvement in visual acuity
of diabetic patients and clinical course of diffuse macular oedema