Repeated intravitreal injection of bevacizumab for clinically significant diabetic macular edema

Abstract

PURPOSE: Intravitreal bevacizumab (Avastin) induces a transient improvement in diabetic macular edema, necessitating repeated injections. Here, we report the results of repeated administration of intravitreal bevacizumab for the treatment of clinically significant macular edema in 31 eyes of 24 patients.

METHODS: At preinjection and 1, 6, and 12 (+/-1) weeks postinjection, visual acuity (VA) with Early Treatment of Diabetic Retinopathy Study (ETDRS) and central macular thickness (CMT) evaluated using optical coherence tomography were compared with independent and paired t-tests.

RESULTS: VA and CMT were not significantly different before initial and repeated injections (administered at an interval of 22.06 +/- 11.15 [SD] weeks). At 6 weeks after the first injection, VA increased significantly by 3.72 +/- 8.02 ETDRS letters (P = 0.019), and CMT was markedly decreased by 93.30 +/- 210.33 microm (P = 0.022), which returned to near baseline at 12 weeks. At 6 weeks after the second injection, VA increased significantly by 3.97 +/- 7.46 ETDRS letters (P = 0.006) and CMT decreased considerably by 118.77 +/- 178.58 microm (P = 0.001). At 12 weeks after the second injection, we observed a decrease in VA with recurrence of macular edema.

CONCLUSIONS: Repeated administration of intravitreal bevacizumab (1.25 mg) may lead to the improvement of VA and CMT in patients with clinically significant macular edema.