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
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 2, Pages 2062-2068
Abstract
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 non-proliferative 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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