title: The effect and safety of intravitreal injection of ranibizumab and bevacizumab on the corneal endothelium in the treatment of diabetic macular edema.
abstract: OBJECTIVE
  To investigate the effect and safety of intravitreal injection (IVI) of bevacizumab and ranibizumab on corneal endothelial cell count and morphology in patients with diabetic macular edema.
  
  
  METHODS
  A total of 60 eyes from 60 consecutive patients who received 0.5 mg/0.05 ml IVIs of bevacizumab (n = 30, IVB group) or 1.25 mg/0.05 ml ranibizumab (n = 30, IVR group) for three consecutive months were investigated prospectively. Specular microscopy was performed to evaluate endothelial cell count, the percentage of hexagonal cells (pleomorphism), and the coefficient of variation of the cell size (polymegathism); optical biometry was performed to evaluate central corneal thickness. Results before injection and 1 month after the first and third injections were compared.
  
  
  RESULTS
  The groups were matched for age (p = 0.11) and gender (p = 0.32). There was no significant difference in endothelial cell count (IVB group, p = 0.66; IVR group, p = 0.74), pleomorphism (IVB group, p = 0.44; IVR group, p = 0.88) and polymegathism (IVB group, p = 0.21; IVR group, p = 0.24) before injection or 1 month after the first and third injections. There was also no difference in central corneal thickness (IVB group, p = 0.15; IVR group, p = 0.58) before injection or 1 month after the first and third injections.
  
  
  CONCLUSIONS
  Monthly 1.25 mg/0.05 ml IVIs of bevacizumab or 0.5 mg/0.05 ml of ranibizumab for three consecutive months in the treatment of diabetic macular edema does not affect corneal morphology and has no harmful effects on the endothelium.
authors.affiliation: a Department of Ophthalmology , Tatvan State Hospital , Bitlis , Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Guzel
authors.affiliation: b Department of Ophthalmology , Selcuk University , Konya , Turkey , and.
authors.forename: Berker
authors.initials: B
authors.lastname: Bakbak
authors.affiliation: c Department of Ophthalmology , Tatvan Military Hospital , Bitlis , Turkey.
authors.forename: Mehmet Talay
authors.initials: MT
authors.lastname: Koylu
authors.affiliation: b Department of Ophthalmology , Selcuk University , Konya , Turkey , and.
authors.forename: Saban
authors.initials: S
authors.lastname: Gonul
authors.affiliation: b Department of Ophthalmology , Selcuk University , Konya , Turkey , and.
authors.forename: Banu
authors.initials: B
authors.lastname: Ozturk
authors.affiliation: b Department of Ophthalmology , Selcuk University , Konya , Turkey , and.
authors.forename: Sansal
authors.initials: S
authors.lastname: Gedik
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000008:administration & dosage / Q000627:therapeutic use*; D003930:Diabetic Retinopathy / Q000188:drug therapy*; D004728:Endothelium, Corneal / Q000033:anatomy & histology / Q000166:cytology / Q000187:drug effects*; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008269:Macular Edema / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab; D000069579:Ranibizumab
keywords: Bevacizumab; corneal endothelial count; diabetic macular edema; ranibizumab; specular microscopy; vascular endothelial growth factor