Online ISSN: 2515-8260

Comparative Evaluation of Efficacy of Intravitreal Bevacizumab (1.25mg) and Laser Monotherapy in Treatment of Diabetic Macular Edema – A Short Term Hospital Based Study in North India

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1Dr. Brijesh Singla, 2Dr. Karamjit Singh,3Dr. Prempal Kaur, 4Dr. Rajesh Kumar, 5Dr. Amanpreet Kaur, 6Dr. Bhuvnesh Singla

Abstract

ABSTRACT Aims: To compare the treatment efficacy of intravitreal bevacizumab (1.25 mg) and laser monotherapy in diabetic macular edema in patients of type 2 diabetes mellitus. Settings and Design: Randomised, non-blinded prospective interventional study conducted in a tertiary care hospital on 66 eyes of type 2 diabetes patients. Methods and Material: After obtaining informed consent, patients diagnosed with nonproliferative diabetic retinopathy (NPDR) and DME defined as clinically significant macular edema (CSME) were recruited in the study. The selected patients were randomized into two groups – group A (n=33) - macular laser photocoagulation and group B (n=33) - three monthly intravitreal bevacizumab injections (1.25 mg). At 3 months follow up, comparison of change in central macular thickness (CMT), macular volume (MV) and best corrected visual acuity (BCVA) was done. Statistical analysis used: SPSS 21, IBM, USA, Pearson’s chi-squared test and two sample t-test. Results: CSME resolved in 11 (33.33%) patients in laser group and 21 (63.64%) patients in the intravitreal bevacizumab group. Mean CMT decreased from 496.03µm to 339.24µm in laser group and from 516.48µm to 283.27µm in the bevacizumab group (p<0.05). Bevacizumab group showed greater reduction in mean MV laser group (p<0.05). Mean BCVA (logMAR) improved from 0.83 to 0.49 in the bevacizumab group while in the laser group, marginal improvement was seen from 0.81 to 0.76 (p<0.001). Conclusions: Intravitreal bevacizumab is superior to macular laser photocoagulation in structural and functional improvement in NPDR with CSME.

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