Anti-VEGF found to improve vision when used for patients with macular edema

San Francisco-In a study conducted by the Pan-American Collaborative Retina Study Group, treatment of diffuse diabetic macular edema (DDME) with bevacizumab (Avastin, Genentech) was shown to improve vision. Bevacizumab is an anti-vascular endothelial growth factor (anti-VEGF) that inhibits abnormal blood vessels.

Improvement was detected after one month. By the end of the 24-month follow-up period, vision had improved in 51.8% of the eyes and 97.1% of the eyes were either stable or improved. The treatment was tested in 115 patients (139 eyes). No serious adverse effects occurred.

The effects of bevacizumab also were reviewed in patients with post-cataract surgery cystoid macular edema (CME) who had not responded to standard treatment.

The researchers reviewed the records of 31 patients (36 eyes) who were treated with at least one intravitreal bevacizumab (IVB) injection and followed for 12 months between 2005 and 2007. At the study's outset the mean best-corrected visual acuity was 20/200, and at 12 months the mean was 20/80. Most eyes (72.2%) improved and the rest remained stable (27.8%). Macular thickness also decreased in most eyes. Patients who received two or more injections were significantly more likely to improve. No adverse systemic or vision side effects or outcomes were reported.

"Large, randomized controlled clinical trials are needed to confirm IVB's efficacy and safety in treating these conditions," said J. Fernando Arevalo, MD, of the Caracas Central Ophthalmologic Clinic, Venezuela. "The results for DDME are very promising and suggest that combining anti-VEGF treatment with laser therapy may prove useful. Also, once further study is completed, unresolved CME post-cataract surgery should be considered for inclusion as an indication for use of IVB."