Bevacizumab yields short-term VA increase in DME

Bevacizumab (Avastin, Genentech) provided a visual acuity (VA) improvement that lasted 36 weeks following one intravitreal injection in patients with diabetic macular edema (DME), said Gholam A. Peyman, MD, of the Vitreoretinal Service, Department of Ophthalmology, University of Arizona School, Tucson.

In a study that included 150 patients, Dr. Peyman and associates compared one injection of bevacizumab (1.25 mg) alone or one injection of bevacizumab with intravitreal triamcinolone acetonide (2 mg) and compared the result with macular photocoagulation as the primary treatment for clinically significant DME. The patients were randomly assigned to one of the three treatment groups.

Dr. Peyman said that VA improved significantly in the bevacizumab group up to 36 weeks and only to 12 weeks in the group that received both bevacizumab and triamcinolone. More re-treatments were found to be necessary in the bevacizumab group compared with the photocoagulation group, with 22% of bevacizumab-treated patients needing a second injection.

"Overall, the superiority of bevacizumab alone or combined with triamcinolone was seen compared with photocoagulation," Dr. Peyman said.

Dr. Peyman concluded that bevacizumab may be an alternative or a first-line treatment for DME. The effect of achieving a decrease in the central macular thickness was transient.