Intravitreal bevacizumab for diabetic macular edema associated with severe capillary loss: one-year results of a pilot study.
OBJECTIVE
To evaluate the effects of intravitreal bevacizumab in patients with diabetic macular edema (DME) associated with severe capillary loss.


METHODS
Multicenter, open-label, nonrandomized study.


METHODS



METHODS
Two tertiary ophthalmic referral centers in Brazil.


METHODS
Ten consecutive patients with DME and "severe" capillary loss.


METHODS
Intravitreal injection(s) of bevacizumab (1.5 mg). Standardized ophthalmic evaluation was performed at baseline and at weeks 8, 16, 24, and 54.


METHODS
Changes in best-corrected visual acuity (BCVA) and in optical coherence tomography variables (central macular thickness [CMT] and total macular volume [TMV]).


RESULTS
Significant changes in BCVA and in CMT/TMV were noted throughout the study (P < .001, P = .009, and P < .001, respectively). The mean logarithm of the minimal angle of resolution Early Treatment Diabetic Retinopathy Study BCVA was 0.786 ( approximately 20/125(+1)) at baseline, 0.646 ( approximately 20/80(-2)) at week 8, 0.580 (20/80(+1)) at week 16, 0.574 ( approximately 20/80(+1)) at week 24, and 0.558 ( approximately 20/80(+2)) at week 54. Compared with baseline, a significant change in BCVA was noted at all follow-up visits (P <or= .008). The mean CMT/TMV values were, respectively, 472.6/10.9 at baseline, 371.4/9.9 at week 8, 359.5/9.8 at week 16, 323.9/9.4 at week 24, and 274.6/8.7 at week 54. Compared with baseline, a significant change in both CMT and TMV was noted only at 24 and 54 weeks (P <or= .007). At 54 weeks, fluorescein angiography demonstrated no change in the extent of macular capillary loss and reduced dye leakage as compared with baseline in all patients.


CONCLUSIONS
Favorable changes in BCVA and in CMT/TMV observed throughout 1 year suggest that intravitreal bevacizumab may be a viable alternative treatment for the management of patients with DME and severe capillary loss.
Bonini-Filho
Marco
M
MacIma-Macular Imaging & Treatment Division, Hospital de Olhos de Araraquara, Araraquara, São Paulo, Brazil.
Costa
Rogério A
RA
Calucci
Daniela
D
Jorge
Rodrigo
R
Melo
Luiz A S
LA
Scott
Ingrid U
IU