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Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 6/2009

01-06-2009 | Retinal Disorders

Comparison of two doses of primary intravitreal bevacizumab (Avastin) for diffuse diabetic macular edema: results from the Pan-American Collaborative Retina Study Group (PACORES) at 12-month follow-up

Authors: J. Fernando Arevalo, Juan G. Sanchez, Jans Fromow-Guerra, Lihteh Wu, Maria H. Berrocal, Michel E. Farah, Jose Cardillo, Francisco J. Rodríguez, for the Pan-American Collaborative Retina Study Group (PACORES)

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 6/2009

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Abstract

Background

To report the 12-month anatomic and ETDRS best-corrected visual acuity (BCVA) response after primary intravitreal bevacizumab (Avastin®) (1.25 mg or 2.5 mg) in patients with diffuse diabetic macular edema (DDME). In addition, a comparison of the two different doses of intravitreal bevacizumab (IVB) utilized was made.

Methods

We reviewed the clinical records of 82 consecutive patients (101 eyes) with DDME in this interventional retrospective multicenter study. All patients with a minimum follow-up of 12 months (mean 57.6 ± 8.4 weeks) were included in this analysis. Patients underwent ETDRS best-corrected visual acuity (BCVA) testing, ophthalmoscopic examination, optical coherence tomography (OCT), and fluorescein angiography (FA) at baseline and follow-up visits.

Results

The mean age of our patients was 59.7 ± 9.3 years. The mean number of IVB injections per eye was three (range: one to six injections) at a mean interval of 14.1 ± 10.5 weeks. In the 1.25 mg group at 1 month BCVA improved from 20/190, logMAR = 0.97 to 20/85, logMAR 0.62, a difference that was statistically significant (p = 0.0001). This improvement was maintained throughout the 3-, 6-, and 12-month follow-up. The mean final BCVA at 12 months was 20/76, logMAR = 0.58 (p < 0.001), a statistically significant difference from baseline BCVA. Similar BCVA changes were observed in the 2.5 mg group. In the 1.25 mg group, the mean central macular thickness (CMT) decreased from 419.1 ± 201.1 µm at baseline to 295.11 ± 91.5 µm at 1 month, 302.1 ± 124.2 µm at 3 months, 313.4.1 ± 96.3 µm at 6 months, and 268.2 ± 95.5 µm at 12 months (p < 0.0001). Similar CMT changes were observed in the 2.5 mg group. Adverse events included transient high blood pressure in one patient (1.2%), transient increased intraocular pressure in one eye (1%), and tractional retinal detachment in one eye (1%).

Conclusions

Primary IVB at doses of 1.25 to 2.5 mg seem to provide stability or improvement in BCVA, OCT, and FA in DDME at 12 months. There seems to be no difference in our results between intravitreal bevacizumab at doses of 1.25 mg or 2.5 mg. In addition, our results suggest the need for at least three injections a year to maintain the BCVA results.
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Metadata
Title
Comparison of two doses of primary intravitreal bevacizumab (Avastin) for diffuse diabetic macular edema: results from the Pan-American Collaborative Retina Study Group (PACORES) at 12-month follow-up
Authors
J. Fernando Arevalo
Juan G. Sanchez
Jans Fromow-Guerra
Lihteh Wu
Maria H. Berrocal
Michel E. Farah
Jose Cardillo
Francisco J. Rodríguez
for the Pan-American Collaborative Retina Study Group (PACORES)
Publication date
01-06-2009
Publisher
Springer-Verlag
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 6/2009
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-008-1034-x

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