Treatment of macular edema in diabetic retinopathy: comparison of the efficacy of intravitreal bevacizumab and ranibizumab injections

Abstract

Aim: To compare the effects of the anti-VEGF treatments bevacizumab and ranibizumab on visual acuity and foveal thickness in macular edema due to diabetic retinopathy. Materials and methods: 50 patients received intravitreal bevacizumab (Avastin; Group 1) and 50 received intravitreal ranibizumab (Group 2). Patients were assessed before and every month for 12 months after injection. Foveal thickness values and best corrected visual acuity were obtained at each assessment. Patients were assessed at 12-month follow-up on BCVA and foveal thickness. Results: BCVA averages for both groups showed a significant increase in visual acuity from pretreatment to 12 month follow-up. The decrease in foveal thickness was also significantly different for both groups from pretreatment to 12 month follow-up. At 12 months, there were no significant between-group differences with respect to a decrease in foveal thickness or an increase in visual acuity. Conclusions: Bevacizumab, compared to ranibizumab, was effective with fewer injections.

Keywords::

• bevacizumab
• diabetus mellitus
• macular edema
• optical coherence tomography
• ranibizumab

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• DME is one of the most important causes of visual impairment in diabetic retinopathy.

• The increase in retinal vascular permeability that develops as a result of the blood–retina barrier breakdown plays an important role in DME's pathogenesis. VEGF is a potent vascular permeability factor and more is produced in response to hypoxia of the retina in patients with diabetic retinopathy.

• Several effective intravitreal treatment modalities are available for the management of DME.

• Both bevacizumab and ranibizumab were found to be effective in the treatment of DME. The number of injections appears to be slightly different with the level of significance being very narrow.

• The effects of intravitreal injections of bevacizumab and ranibizumab, on DME and frequency of intravitreal injections should be explored in the future with a larger group of patients and longer follow-up durations.

Notes