Management of Diabetic Macular Edema with Intravitreal Bevacizumab: a Prospective Study

Diabetic macular edema (DME) is a manifestation of diabetic retinopathy that produces loss of central vision. Newer management modalities are being tried globally for diabetic macular edema. In the recent years, off-label anti-VEGFs especially bevacizumab in conjunct to grid laser is becoming popular.

To evaluate the efficacy of intravitreal bevacizumab on diabetic macular edema

In this prospective study, 36 eyes from 48 patients were diagnosed as diabetic macular edema. The eyes were subjected to complete ocular examination. 1.25mg/0.05ml of bevacizumab was given and evaluated for central macular thickness at 1month and 3 months intervals. Grid laser was carried out, once the macular thickness reduced to satisfactory levels. If required, 2nd dose of bevacizumab was given.

Of the 36 eyes, 72% maintained normal macular thickness at the end of 3 months, 19% of the eyes required 2nd dose of bevacizumab. 28% did not show satisfactory results for which further intervention was done at the end of 3 months.

Intravitreal injection of 1.25mg bevacizumab was well tolerated by our study group and a Combined Intravitreal bevacizumab and grid laser showed better anatomical and functional improvement in most of our study subjects. However, for long term safety and efficacy, many more long term studies are required.