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Clinical science
Intravitreal bevacizumab for diabetic macular oedema: 5-year results of the Pan-American Collaborative Retina Study group
  1. J Fernando Arevalo1,
  2. Andres F Lasave2,
  3. Lihteh Wu3,
  4. Dhariana Acon3,
  5. Michel E Farah4,
  6. Roberto Gallego-Pinazo5,
  7. Arturo A Alezzandrini6,
  8. Veronica Fortuna6,
  9. Hugo Quiroz-Mercado7,
  10. Guillermo Salcedo-Villanueva7,
  11. Mauricio Maia4,
  12. Martin Serrano8,
  13. Sergio Rojas9
  14. for the Pan-American Collaborative Retina Study Group (PACORES)
  1. 1Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
  2. 2Retina and Vitreous Service, Clínica Privada de Ojos, Mar del Plata, Argentina
  3. 3Retina Service, Instituto de Cirugia Ocular, San Jose, Costa Rica
  4. 4Retina Division, Retina Division, Department of Ophthalmology and Visual Sciences, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
  5. 5Department of Ophthalmology, Consorcio Hospital, General Universitario de Valencia, Valencia, Spain
  6. 6Facultad de Medicina, OFTALMOS, Universidad de Buenos Aires, Buenos Aires, Argentina
  7. 7Department of Ophthalmology, University of Colorado School of Medicine, Denver, Colorado, USA
  8. 8Retina Service, Clinica Oftalmologica Centro Caracas and the Arevalo-Coutinho Foundation for Research in Ophthalmology, Caracas, Venezuela
  9. 9Retina Service, Fundación Hospital Nuestra Señora de la Luz, Mexico City, Mexico
  1. Correspondence to Dr J Fernando Arevalo, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Maumenee 708, Baltimore, MD 21287, USA; arevalojf{at}jhmi.edu

Abstract

Background/aims To report the long-term anatomical and functional outcomes of patients with centre-involved diabetic macular oedema (DME) treated with intravitreal bevacizumab (IVB).

Methods Retrospective case series. Patients diagnosed with centre-involved DME that were treated with at least one injection of 1.25 mg IVB and had a minimum follow-up of 60 months. Patients underwent measurement of best-corrected visual acuity (BCVA), ophthalmoscopy, optical coherence tomography and fluorescein angiography at baseline, 6-month, 12-month, 24-month, 36-month, 48-month and 60-month visits. The paired samples t test was used to compare the central macular thickness (CMT) and BCVA with baseline values. Statistical significance was indicated by p<0.05.

Results Two hundred and one consecutive patients (296 eyes) were included. The mean number of IVB injections per eye was 8.4±7.1 (range: 1–47 injections). At 5 years, the BCVA remained stable at 20/100 (logarithm of the minimum angle of resolution=0.7±0.4). Eighty-six (29%) eyes improved ≥2 lines of BCVA, 129 (43.6%) eyes remained stable and 81 (27.4%) eyes lost ≥2 lines of BCVA at 60 months. Mean CMT decreased from 403.5±142.2 μm at baseline to 313.7±117.7 μm over 5 years follow-up (p≤0.0001).

Conclusions The early visual gains due to IVB were not maintained 5 years after treatment.

  • Treatment Medical
  • Retina
  • Posterior Chamber
  • Neovascularisation
  • Macula

https://doi.org/10.1136/bjophthalmol-2015-307950

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    Footnotes

    • Presented in part at the Annual Meeting of the American Academy of Ophthalmology, and the Retina Subspecialty Day, Chicago, Illinois, October 2014.

    • Collaborators For a complete listing of the participating members of Pan-American Collaborative Retina Study, see the online supplementary appendix.

    • Contributors All authors have given final approval of this version to be published. JFA, AFL, DA, MM and SR participated in drafting the manuscript, study design, data collection and screening, data-analysis and evidence synthesis, and revising the manuscript. LW, MEF, RG-P, AAA, VF, HQ-M, GS-V, MM and MS participated in literature search, data collection, data-analysis and evidence synthesis and drafting the manuscript. JFA, LW and AFL participated in hypothesis generation, evidence synthesis and revising the manuscript. JFA, AFL, DA, MEF, RG-P, AAA, VF, HQ-M, GS-V, MM, MS and SR participated in study design, data collection, screening and revising the manuscript.

    • Competing interests JFA is a consultant to Second Sight LLC, Alcon Laboratories, Engineering, DORC International BV and Bayer AG.

    • Ethics approval Each participating centre's institutional ethics committee approved this study.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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