Original ArticlePrimary Intravitreal Bevacizumab (Avastin) for Diabetic Macular Edema: Results from the Pan-American Collaborative Retina Study Group at 6-Month Follow-up
Section snippets
Patients and Methods
We conducted a multicenter retrospective study of eyes with DME treated with off-label intravitreal bevacizumab (Avastin) between September 2005 and August 2006 at 6 institutions in Venezuela, Mexico, Costa Rica, Brazil, Puerto Rico, and Colombia. We reviewed the clinical records of 88 consecutive patients (110 eyes) with DME treated with at least one intravitreal injection of 1.25 mg or 2.5 mg of bevacizumab. Institutional review board/ethics committee approval and patients’ informed consent
Results
Seventy-eight eyes (64 consecutive patients) with a minimum of 6 months’ follow-up were included for analysis. Fifty-one (79.7%) patients were Hispanic and 12 (18.7%) were Caucasian. Our patients had a mean age of 59.7±9.3 years, and 54.7% were male (35 men, 29 women). Patients had a mean follow-up of 6.31±0.81 months (range, 6–9). Forty-four (56.4%) cases had PDR (Table 1). All of these 44 cases had had prior scatter photocoagulation at least 6 months before undergoing bevacizumab intravitreal
Discussion
Diabetic macular edema is a manifestation of diabetic retinopathy that produces loss of central vision. Although several treatment modalities are under investigation, the only demonstrated means to reduce the risk of vision loss from DME are laser photocoagulation, as demonstrated by the ETDRS4; intensive glycemic control, as demonstrated by the Diabetes Control and Complications Trial and the United Kingdom Prospective Diabetes Study; and blood pressure control, as demonstrated by the United
References (31)
- et al.
The Wisconsin Epidemiologic Study of Diabetic RetinopathyIV. Diabetic macular edema
Ophthalmology
(1984) - et al.
Macular edema: a complication of diabetic retinopathy
Surv Ophthalmol
(1984) Diabetic maculopathy: a critical review highlighting diffuse macular edema
Ophthalmology
(1983)- et al.
Increased vascular endothelial growth factor levels in the vitreous of eyes with proliferative diabetic retinopathy
Am J Ophthalmol
(1994) - et al.
Pathologic features of vascular endothelial growth factor-induced retinopathy in the nonhuman primate
Am J Ophthalmol
(2002) - et al.
Intravitreous injections of vascular endothelial growth factor produce retinal ischemia and microangiopathy in an adult primate
Ophthalmology
(1996) - et al.
A pilot study of multiple intravitreal injections of ranibizumab in patients with center-involving clinically significant diabetic macular edema
Ophthalmology
(2006) - et al.
Modified grid laser photocoagulation for diffuse diabetic macular edema: long-term visual results
Ophthalmology
(1991) - et al.
Safe and effective
Ophthalmology
(2003) - et al.
Global and societal implications of the diabetes epidemic
Nature
(2001)
Medical interventions for diabetic retinopathy
Photocoagulation for diabetic macular edemaEarly Treatment Diabetic Retinopathy Study report number 1
Arch Ophthalmol
Vascular endothelial growth factor: basic science and clinical progress
Endocr Rev
Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders
N Engl J Med
Detection of vascular endothelial growth factor messenger RNA and vascular endothelial growth factor-like activity in proliferative diabetic retinopathy
Arch Ophthalmol
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Manuscript no. 2006-1152.
Supported in part by the Arevalo–Coutinho Foundation for Research in Ophthalmology, Caracas, Venezuela.
The authors have no financial or proprietary interest in any of the products or techniques mentioned in the article.