Intravitreal Bevacizumab for Diabetic Macular Edema Associated With Severe Capillary Loss: One-Year Results of a Pilot Study

Marco Bonini-Filho, Rogério A. Costa, Daniela Calucci, Rodrigo Jorge, Luiz A.S. Melo, Ingrid Scott

Research output: Contribution to journalArticle

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Abstract

Purpose: To evaluate the effects of intravitreal bevacizumab in patients with diabetic macular edema (DME) associated with severe capillary loss. Design: Multicenter, open-label, nonrandomized study. Methods: setting: Two tertiary ophthalmic referral centers in Brazil. study population: Ten consecutive patients with DME and "severe" capillary loss. observation procedures: Intravitreal injection(s) of bevacizumab (1.5 mg). Standardized ophthalmic evaluation was performed at baseline and at weeks 8, 16, 24, and 54. main outcome measures: Changes in best-corrected visual acuity (BCVA) and in optical coherence tomography variables (central macular thickness [CMT] and total macular volume [TMV]). Results: Significant changes in BCVA and in CMT/TMV were noted throughout the study (P < .001, P = .009, and P < .001, respectively). The mean logarithm of the minimal angle of resolution Early Treatment Diabetic Retinopathy Study BCVA was 0.786 (∼20/125+1) at baseline, 0.646 (∼20/80-2) at week 8, 0.580 (20/80+1) at week 16, 0.574 (∼20/80+1) at week 24, and 0.558 (∼20/80+2) at week 54. Compared with baseline, a significant change in BCVA was noted at all follow-up visits (P ≤ .008). The mean CMT/TMV values were, respectively, 472.6/10.9 at baseline, 371.4/9.9 at week 8, 359.5/9.8 at week 16, 323.9/9.4 at week 24, and 274.6/8.7 at week 54. Compared with baseline, a significant change in both CMT and TMV was noted only at 24 and 54 weeks (P ≤ .007). At 54 weeks, fluorescein angiography demonstrated no change in the extent of macular capillary loss and reduced dye leakage as compared with baseline in all patients. Conclusions: Favorable changes in BCVA and in CMT/TMV observed throughout 1 year suggest that intravitreal bevacizumab may be a viable alternative treatment for the management of patients with DME and severe capillary loss.

Original languageEnglish (US)
JournalAmerican Journal of Ophthalmology
Volume147
Issue number6
DOIs
StatePublished - Jan 1 2009

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Macular Edema
Visual Acuity
Intravitreal Injections
Fluorescein Angiography
Optical Coherence Tomography
Diabetic Retinopathy
Tertiary Care Centers
Brazil
Coloring Agents
Observation
Outcome Assessment (Health Care)
Bevacizumab
Therapeutics
Population

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Bonini-Filho, Marco ; Costa, Rogério A. ; Calucci, Daniela ; Jorge, Rodrigo ; Melo, Luiz A.S. ; Scott, Ingrid. / Intravitreal Bevacizumab for Diabetic Macular Edema Associated With Severe Capillary Loss : One-Year Results of a Pilot Study. In: American Journal of Ophthalmology. 2009 ; Vol. 147, No. 6.
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title = "Intravitreal Bevacizumab for Diabetic Macular Edema Associated With Severe Capillary Loss: One-Year Results of a Pilot Study",
abstract = "Purpose: To evaluate the effects of intravitreal bevacizumab in patients with diabetic macular edema (DME) associated with severe capillary loss. Design: Multicenter, open-label, nonrandomized study. Methods: setting: Two tertiary ophthalmic referral centers in Brazil. study population: Ten consecutive patients with DME and {"}severe{"} capillary loss. observation procedures: Intravitreal injection(s) of bevacizumab (1.5 mg). Standardized ophthalmic evaluation was performed at baseline and at weeks 8, 16, 24, and 54. main outcome measures: Changes in best-corrected visual acuity (BCVA) and in optical coherence tomography variables (central macular thickness [CMT] and total macular volume [TMV]). Results: Significant changes in BCVA and in CMT/TMV were noted throughout the study (P < .001, P = .009, and P < .001, respectively). The mean logarithm of the minimal angle of resolution Early Treatment Diabetic Retinopathy Study BCVA was 0.786 (∼20/125+1) at baseline, 0.646 (∼20/80-2) at week 8, 0.580 (20/80+1) at week 16, 0.574 (∼20/80+1) at week 24, and 0.558 (∼20/80+2) at week 54. Compared with baseline, a significant change in BCVA was noted at all follow-up visits (P ≤ .008). The mean CMT/TMV values were, respectively, 472.6/10.9 at baseline, 371.4/9.9 at week 8, 359.5/9.8 at week 16, 323.9/9.4 at week 24, and 274.6/8.7 at week 54. Compared with baseline, a significant change in both CMT and TMV was noted only at 24 and 54 weeks (P ≤ .007). At 54 weeks, fluorescein angiography demonstrated no change in the extent of macular capillary loss and reduced dye leakage as compared with baseline in all patients. Conclusions: Favorable changes in BCVA and in CMT/TMV observed throughout 1 year suggest that intravitreal bevacizumab may be a viable alternative treatment for the management of patients with DME and severe capillary loss.",
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Intravitreal Bevacizumab for Diabetic Macular Edema Associated With Severe Capillary Loss : One-Year Results of a Pilot Study. / Bonini-Filho, Marco; Costa, Rogério A.; Calucci, Daniela; Jorge, Rodrigo; Melo, Luiz A.S.; Scott, Ingrid.

In: American Journal of Ophthalmology, Vol. 147, No. 6, 01.01.2009.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intravitreal Bevacizumab for Diabetic Macular Edema Associated With Severe Capillary Loss

T2 - One-Year Results of a Pilot Study

AU - Bonini-Filho, Marco

AU - Costa, Rogério A.

AU - Calucci, Daniela

AU - Jorge, Rodrigo

AU - Melo, Luiz A.S.

AU - Scott, Ingrid

PY - 2009/1/1

Y1 - 2009/1/1

N2 - Purpose: To evaluate the effects of intravitreal bevacizumab in patients with diabetic macular edema (DME) associated with severe capillary loss. Design: Multicenter, open-label, nonrandomized study. Methods: setting: Two tertiary ophthalmic referral centers in Brazil. study population: Ten consecutive patients with DME and "severe" capillary loss. observation procedures: Intravitreal injection(s) of bevacizumab (1.5 mg). Standardized ophthalmic evaluation was performed at baseline and at weeks 8, 16, 24, and 54. main outcome measures: Changes in best-corrected visual acuity (BCVA) and in optical coherence tomography variables (central macular thickness [CMT] and total macular volume [TMV]). Results: Significant changes in BCVA and in CMT/TMV were noted throughout the study (P < .001, P = .009, and P < .001, respectively). The mean logarithm of the minimal angle of resolution Early Treatment Diabetic Retinopathy Study BCVA was 0.786 (∼20/125+1) at baseline, 0.646 (∼20/80-2) at week 8, 0.580 (20/80+1) at week 16, 0.574 (∼20/80+1) at week 24, and 0.558 (∼20/80+2) at week 54. Compared with baseline, a significant change in BCVA was noted at all follow-up visits (P ≤ .008). The mean CMT/TMV values were, respectively, 472.6/10.9 at baseline, 371.4/9.9 at week 8, 359.5/9.8 at week 16, 323.9/9.4 at week 24, and 274.6/8.7 at week 54. Compared with baseline, a significant change in both CMT and TMV was noted only at 24 and 54 weeks (P ≤ .007). At 54 weeks, fluorescein angiography demonstrated no change in the extent of macular capillary loss and reduced dye leakage as compared with baseline in all patients. Conclusions: Favorable changes in BCVA and in CMT/TMV observed throughout 1 year suggest that intravitreal bevacizumab may be a viable alternative treatment for the management of patients with DME and severe capillary loss.

AB - Purpose: To evaluate the effects of intravitreal bevacizumab in patients with diabetic macular edema (DME) associated with severe capillary loss. Design: Multicenter, open-label, nonrandomized study. Methods: setting: Two tertiary ophthalmic referral centers in Brazil. study population: Ten consecutive patients with DME and "severe" capillary loss. observation procedures: Intravitreal injection(s) of bevacizumab (1.5 mg). Standardized ophthalmic evaluation was performed at baseline and at weeks 8, 16, 24, and 54. main outcome measures: Changes in best-corrected visual acuity (BCVA) and in optical coherence tomography variables (central macular thickness [CMT] and total macular volume [TMV]). Results: Significant changes in BCVA and in CMT/TMV were noted throughout the study (P < .001, P = .009, and P < .001, respectively). The mean logarithm of the minimal angle of resolution Early Treatment Diabetic Retinopathy Study BCVA was 0.786 (∼20/125+1) at baseline, 0.646 (∼20/80-2) at week 8, 0.580 (20/80+1) at week 16, 0.574 (∼20/80+1) at week 24, and 0.558 (∼20/80+2) at week 54. Compared with baseline, a significant change in BCVA was noted at all follow-up visits (P ≤ .008). The mean CMT/TMV values were, respectively, 472.6/10.9 at baseline, 371.4/9.9 at week 8, 359.5/9.8 at week 16, 323.9/9.4 at week 24, and 274.6/8.7 at week 54. Compared with baseline, a significant change in both CMT and TMV was noted only at 24 and 54 weeks (P ≤ .007). At 54 weeks, fluorescein angiography demonstrated no change in the extent of macular capillary loss and reduced dye leakage as compared with baseline in all patients. Conclusions: Favorable changes in BCVA and in CMT/TMV observed throughout 1 year suggest that intravitreal bevacizumab may be a viable alternative treatment for the management of patients with DME and severe capillary loss.

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