Comparing the Effect of Interavitreal Bevacizumab in Visual Acuity of Ischemic and Non-Ischemic Diabetic Macular Edema

Background : The paper tries to examine the effect of avastin on visual acuity in patients with Ischemic and non-ischemic diabetic macular edema which was estimated convenient, inexpensive, safe, and quick in contrast to laser or deep vitrectomy.
Materials and Methods : In this clinical trial study, patients with clinically significant macular edema (CSMA) were subjected to fluorescein angiography (FA) and people whose foveal avascular zones (FAZ) were over 1000 µm were defined as ischemic diabetic macular edema. Patients were divided into two ischemic and non-ischemic groups. The best corrected visual acuity (BCVA) and the central macular thickness (CMT) in all eyes were measured and recorded by optical coherence tomography (OCT). All patients received 3 vitreous injections of bevacizumab (avastin) at 1-month intervals. One month after the third injection, BCVA and CMT were measured again and patient’s information was compared before and after the injection.
Results : Out of 87 eyes (66 patients), 23 eyes (26.4%) belonged to ischemic group and 64 eyes (73.6%) belonged to non-ischemic group. In ischemic group, BCVA improved from 0.653 ±0.309 LogMAR to 0.404 ±0.255 LogMAR (p=0.001), while no significant change was seen in non-ischemic group (from 0.881 ±0.332 to 0.879 ±0.378). In ischemic group, CMT was increased from 362.9±34.66 to 278.76 ± 45.57 and in non-ischemic group it was enhanced from 353.47 ±67.61 to 239.87±55.44 (p=0.001).
Conclusion : In spite of the great impact of vitreous injection of avastin in reducing the central macular thickness in both ischemic and non-ischemic groups and sensible improvement of patients’ visibility, the visibility itself was not improved considerably in ischemic group.