THE OUTCOMES OF INTRAVITREAL BEVACIZUMAB

VERSUS COMBINED TREATMENT IN PATIENTS

WITH DIABETIC MACULAR EDEMA: A

COMPARATIVE STUDY

Dr. Shilpa. G

Fellow in Vitreo-retina

M.M. Joshi Eye Institute Hubli,

Karnataka, India

Dr. A.S. Guruprasad

Head of Vitreo-retina

Department

M.M. Joshi Eye Institute Hubli,

Karnataka, India

Dr. Shrinivas. M. Joshi

Consultant

Vitreo-retina Department

M. M. Joshi Eye Institute

Hubli, Karnataka, India

DR. TRIPTI KOLHATKARVitreo-Retina Consultant, M M Joshi Eye Institute

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INTRODUCTION

• In diabetic macular edema focal/grid photocoagulation was considered a standard therapy(as per ETDRS), till anti-VEGF role was established.

•An anti-VEGF agent reduces the macular edema by decreasing vascular permeability. The effect however is short leading to need for repeated injections.

THE OUTCOMES OF INTRAVITREAL BEVACIZUMAB VERSUS COMBINED TREATMENT IN

PATIENTS WITH DIABETIC MACULAR EDEMA: A COMPARATIVE STUDY

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• To study the anatomical and functional outcomes of bevacizumab monotherapy and combination therapy with Mild Macular Grid (MMG) laser in DME in NPDR patients and to compare the results between the two groups.

AIMS & OBJECTIVES

THE OUTCOMES OF INTRAVITREAL BEVACIZUMAB VERSUS COMBINED TREATMENT IN

PATIENTS WITH DIABETIC MACULAR EDEMA: A COMPARATIVE STUDY

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THE OUTCOMES OF INTRAVITREAL BEVACIZUMAB VERSUS COMBINED TREATMENT IN

PATIENTS WITH DIABETIC MACULAR EDEMA: A COMPARATIVE STUDY

MATERIALS & METHODS

• Study was carried out in Vitreo-Retina department of M M Joshi Eye Institute, Hubli, Karnataka, India

• 75 NPDR eyes having DME were divided into two Groups.

• Group 1: Received IVB only

• Group 2: Recieved IVB followed by MMG

• Group 2A: 1 IVB followed by MMG

• Group 2B: 3 IVB followed by MMG

• Follow up period was 9 months

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OUTCOME MEASURES

Visual acuity and Central Macular Thickness at the end of 9 months of follow up

THE OUTCOMES OF INTRAVITREAL BEVACIZUMAB VERSUS COMBINED TREATMENT IN

PATIENTS WITH DIABETIC MACULAR EDEMA: A COMPARATIVE STUDY

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RESULTS & OBSERVATIONS

Baseline Values

Groups No of Patients Baseline CMT Baseline VA

Group 1 26 444.34 0.98

Group 2A 25 379.72 0.82

Group 2B 24 411.02 1.03

THE OUTCOMES OF INTRAVITREAL BEVACIZUMAB VERSUS COMBINED TREATMENT IN

PATIENTS WITH DIABETIC MACULAR EDEMA: A COMPARATIVE STUDY

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Baseline CMT Follow up 1

month

Follow up 9

month

444.34 286.08 283.65

379.72 258.44 263.2

411.02 243.96 242.79

Central Macular Thickness

Group 1 Group 2A Group 2B

Baseline VA Follow up 1

month

Follow up 9

month

0.98 0.37 0.46

0.820.38 0.41

1.030.26 0.26

Visual Acuity

Group 1 Group2A Group 2B

THE OUTCOMES OF INTRAVITREAL BEVACIZUMAB VERSUS COMBINED TREATMENT IN

PATIENTS WITH DIABETIC MACULAR EDEMA: A COMPARATIVE STUDY

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THE OUTCOMES OF INTRAVITREAL BEVACIZUMAB VERSUS COMBINED TREATMENT IN

PATIENTS WITH DIABETIC MACULAR EDEMA: A COMPARATIVE STUDY

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CONCLUSIONS & IMPLICATIONS

•IVB followed by MMG provided cost effective statistically significant (p= <0.0001)

favorable results by decreasing the macular edema & improving the visual acuity for a

longer period of time.

•But the study needs to be conducted over a larger sample size for a longer duration of

time to confirm the results.

THE OUTCOMES OF INTRAVITREAL BEVACIZUMAB VERSUS COMBINED TREATMENT IN

PATIENTS WITH DIABETIC MACULAR EDEMA: A COMPARATIVE STUDY

Progression of cataract was seen with no

statistically significant difference among

the groups (p=0.774).

No other complications noted.

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References

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THE OUTCOMES OF INTRAVITREAL BEVACIZUMAB VERSUS COMBINED TREATMENT IN

PATIENTS WITH DIABETIC MACULAR EDEMA: A COMPARATIVE STUDY

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