Long-term use of intravitreous bevacizumab treats CSME

The long-term use of intravitreous bevacizumab can be used to treat patients with persistant clinically significant macula oedema (CSME), claims a study in the Archives of Ophthalmology.

Dr Ranjan Rajendram et al., Department of Medical Retina, Moorfields Eye Hospital, London, UK, conducted a two year single-centred, randomized, controlled trial on 80 CSME patients. Each participant was randomized to receive either bevacizumab or macular laser therapy (MLT).

The primary outcome was difference in Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA). The secondary outcomes were mean change in best-corrected visual acuity (BCVA), central macula thickness changes, ETDRS retinopathy severity, safety outcomes and the propertion of patients gaining a minimum of 15 and 10 ETDRS letters.

At two years the mean ETDRS BCVA was 64.4 for the bevacizumab group and 54.8 for the MLT group. A median of nine ETDRS letters was gained in the bevacizumab group and 2.5 letters were gained in the MLT group.

In the bevacizumab group 49% gained 10 or more letters and 32% gained 15 letters. In the MLT group 7% and 4% of patients gained 10 and 15 letters, respectively. In the bevacizumab group all patients lost fewer than 15 letters, compared to 86% in the MLT group.

At 146 µm the mean reduction in central macular thickness was considerably higher in the bevacizumab group, compared to 118 µm in the MLT group. The improvements seen in BCVA and central macular thickness were maintained in second year with an average of four injections.