Intravitreal bevacizumab plus macular laser photocoagulation for treatment of diabetic macular edema

Abstract

Purpose The aim of the study was to evaluate the visual outcome and central macular thickness (CMT) after intravitreal injection of bevacizumab in conjunction with macular laser photocoagulation (MLP) for the treatment of diabetic macular edema (DME). Patients and methods This is a prospective, interventional, case study. A total of 32 eyes were included in this study. The following data were recorded at baseline and during the follow-up periods (≤6 months): best-corrected visual acuity (BCVA), CMT, fluorescein angiography, slit-lamp biomicroscopy, and intraocular pressure measurement by applanation tonometry. All eyes received intravitreal bevacizumab at a dose of 1.25 mg in 0.05 ml 2 weeks before MLP, which was applied in a focal or grid pattern according to the treatment map. Results This study included 32 eyes of 27 patients, 16 of whom were men and 11 were women. The mean baseline BCVA was 0.29 ± 0.11 decimal Snellen’s equivalent, and the final mean BCVA was 0.38 ± 0.13. Analysis of the final BCVA revealed that 15 (47%) eyes improved by two or more lines of BCVA, 16 (50%) eyes remained stable, and one (3%) eye lost one line of BCVA. Mean CMT at baseline was 625.18 ± 82.88 μm, which decreased to a mean of 283.46 ± 22.47 μm at the end of the follow-up period covering 6 months. Conclusion Primary treatment for DME with intravitreal bevacizumab in conjunction with MLP results in improvement or stabilization of BCVA and reduces CMT. Combined therapy seems to be an effective modality for treatment of DME.