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Diabetes Res Clin Pract. 2019 Mar;149:170-178. doi: 10.1016/j.diabres.2019.02.002. Epub 2019 Feb 11.

Short-term effects of intravitreal bevacizumab in contrast sensitivity of patients with diabetic macular edema and optimizing glycemic control.

Author information

1
Division of Ophthalmology, University of São Paulo, São Paulo Medical School, São Paulo, Brazil. Electronic address: medmotta@hotmail.com.
2
Division of Ophthalmology, University of São Paulo, São Paulo Medical School, São Paulo, Brazil.
3
Division of Ophthalmology, University of São Paulo, São Paulo Medical School, São Paulo, Brazil; Ocular Imaging Research & Reading Center, Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, United States.
4
Department of Ophthalmology & Visual Sciences, University of Louisville, United States.
5
Division of Endocrinology & Metabolism, Department of Diabetes, University of São Paulo, São Paulo Medical School, São Paulo, Brazil.

Abstract

AIMS:

To analyze contrast sensitivity of intravitreal bevacizumab injections with optimizing glycemic control versus optimizing glycemic control (in combination with sham injections) in eyes with Diabetic Macular Edema (DME).

DESIGN:

Prospective, interventional, masked, randomized controlled trial.

METHODS:

Forty-one eyes of 34 patients with type 2 diabetes mellitus and DME with glycated hemoglobin (HbA1c) < 11% received either intravitreal bevacizumab injection (Group 1) or sham injection (Group 2) at 0 and 6 weeks along with optimizing glycemic control. Mean change in best-corrected visual acuity (BCVA), contrast sensitivity (CS), optical coherence tomography (OCT)-measured by central macular thickness (CMT) were compared and correlated at baseline, 2, 6 and 12 weeks.

RESULTS:

The study showed a mean CS improved in group 1 from 1.14 ± 0.36 logCS to 1.32 ± 0.24 logCS and also in group 2 from 1.11 ± 0.29 logCS to 1.18 ± 0.29 logCS at 12 weeks (P = 0.12). CS and CMT promptly decreased in group 1 compared to group 2 at 2 weeks (ΔCS = 0.15 ± 0.25 vs. 0.03 ± 0.15 logCS; P = 0.04; ΔCMT = 116 ± 115 vs. 17 ± 71 μm; P = 0.01). There was a mean reduction of approximately 0.5% in HbA1c levels in both groups at 12 weeks (P = 0.002).

CONCLUSION:

The use of bevacizumab in combination with optimizing glycemic control results in earlier improvement of contrast sensitivity in type 2 diabetes patients with DME. However, the optimizing glycemic control itself has shown also to be effective at 12 weeks. ClinicalTrials.gov Identifier: NCT02308644.

KEYWORDS:

Bevacizumab; Contrast sensitivity; Diabetic macular edema; Glycemic control

PMID:
30763599
DOI:
10.1016/j.diabres.2019.02.002
[Indexed for MEDLINE]

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