Intravitreal bevacizumab alone or combined with macular laser for treatment of diabetic macular edema

Abstract

Purpose: We aimed to evaluate the best-corrected visual acuity (BCVA) and assess improvement of central macular thickness (CMT) in patients with diffuse diabetic macular edema (DDME) after an intravitreal injection of bevacizumab (Avastin®) alone, or followed by modified grid macular laser photocoagulation. Subjects and Methods: This was a randomized prospective interventional study that included 78 eyes of 40 patients with DDME, divided into two groups of interventions: Group A received bevacizumab (Avastin®) injections monthly for 3 months then pro re nata, and Group B received bevacizumab as Group A but followed by grid macular laser photocoagulation 2 weeks after the first injection. Patients were observed monthly for a 12-month period and their BCVA, intraocular pressure, and CMT were recorded. Results: Compared with the baseline, there was a significant decrease of CMT in both groups of patients (−138.3 ± 40.15 vs. −156.5 ± 33.47, respectively). The improvement in ME was more in the combined group than the Avastin® group (P < 0.0001). After 12-month follow-up, the mean average change in visual acuity letter score was significantly improved in both groups (P < 0.018 and < 0.002, respectively). Conclusion: Combined Avastin® and modified grid macular photocoagulation led to more stable improvement in the treatment of eyes with DDME.