Bevacizumab Offers Lasting Improvement in Macular Edema

Best-corrected visual acuity significantly improved at two years for patients with diabetes-related CSME

THURSDAY, April 12 (HealthDay News) -- At two years of follow-up, diabetes-related clinically significant macular edema (CSME) is more effectively improved by intravitreous bevacizumab than with macular laser therapy (MLT), according to a study published online April 9 in the Archives of Ophthalmology.

Ranjan Rajendram, M.D., of Moorfields Eye Hospital in London, and colleagues randomized 80 patients with center-involving CSME and visual acuity of 20/40 to 20/320 to receive either bevacizumab or MLT. The outcomes were reported at two years.

At two years, the researchers found that the mean Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity was significantly better in the bevacizumab arm than the MLT arm (64.4 versus 54.8; P = 0.005). The bevacizumab arm gained significantly more ETDRS letters than the MLT arm (median of nine versus 2.5; mean gain of 8.6 versus mean loss of 0.5). At least 10 letters were gained by 49 percent and at least 15 by 32 percent in the bevacizumab arm, compared with 7 and 4 percent, respectively, in the MLT arm. Central macular thickness was reduced by a mean 146 µm in the bevacizumab arm, compared with 118 µm in the MLT arm. The bevacizumab group received a median of 13 treatments over the 24 months, while the MLT group received four.

"This study provides evidence supporting longer-term use of intravitreous bevacizumab for persistent center-involving CSME," the authors write.

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