TY - JOUR
TI - Intravitreal bevacizumab injection alone or combined with macular photocoagulation compared to macular photocoagulation as primary treatment of diabetic macular edema
AU - Jovanović Sandra
AU - Čanadanović Vladimir
AU - Sabo Ana
AU - Grgić Zorka
AU - Mitrović Milena
AU - Rakić Dušan
JN - Vojnosanitetski pregled
PY - 2015
VL - 72
IS - 10
SP - 876
EP - 882
PT- Article
AB- Background/Aim. Within diabetic retinopathy (DR), diabetic macular edema
   (DME) is one of the leading causes of the loss of visual acuity. The aim of
   this study was to determine the efficacy of the intravitreal vascular
   endothelial growth factor (VEGF) inhibitor application alone or combined
   with macular focal/grid lasephotocoagulation compared with laser treatment
   alone. Methods. This prospective randomized clinical trial included 72
   patients (120 treated eyes) with varying degrees of DR and DME. The DME
   treatment included intravitreal VEGF inhibitor bevacizumab (Avastin®)
   application, with and without laser treatment. Bevacizumab (1.25 mg/0.05 mL)
   was administered intravitreally in 4-6-week intervals. Laser is applied 4-6
   weeks after last dose of the drug as a part of combined treatment, or as the
   primary treatment. Results. The mean reduction in central macular thickness
   (CMT) for the eyes (n = 31) treated with bevacizumab alone was 162.23 μm,
   for the eyes (n = 53) treated with combined treatment the mean reduction in
   CMT was 124.24 μm, both statistically significant at p < 0.001. Laser
   macular photocolagulation as a part of combined treatment (in 53 eyes)
   significantly contributed to the CMT reduction, based on the paired t-test
   results (366.28 vs 323.0 μm at p < 0.05). In our study, the mean visual
   acuity improvement of 0.161 logMAR was achieved in the group of eyes treated
   with bevacizumab alone, and 0.093 logMAR in the group with combined
   treatment, both statistically significant at p < 0.05. The effect of laser
   photocolagulation alone on visual acuity and CMT was not statistically
   significant. Conclusion. Treatment with bevacizumab alone or within combined
   treatment is more effective in treating DME than conventional macular laser
   treatment alone, both anatomically and functionally.