Paired Responses to Intravitreal Bevacizumab in Diabetic Macular Edema: Predictors of Response in the Fellow Eye

Overview

Journal Graefes Arch Clin Exp Ophthalmol

Specialty Ophthalmology

Date 2013 Jul 23

PMID 23873254

Citations 2

Authors

Peter A Karth

Anne Chang

William Wirostko

Affiliations

Soon will be listed here.

Abstract

Background: Factors predictive for response of diabetic macular edema (DME) to intravitreal bevacizumab (IVB) remain unclear. In this study, we assess the predictability of DME response to IVB based on the response to IVB in a previously treated fellow eye and other known pre-injection factors in (DME).

Methods: Retrospective chart review was conducted on 28 patients (56 eyes) with bilateral DME who underwent bilateral IVB therapy. Responses in both eyes were measured by change in central subfield thickness (CSFT) via optic coherence tomography (OCT), and change in visual acuity. Age, lens status, and starting macular thickness were recorded.

Results: We found 21 % of the reduction in CSFT after IVB on OCT in the study eye may be explained by the percentage change in CSFT in the previously treated fellow eye [CI: 0.092-0.716; p-value = 0.0141]. Also, the pre-injection CSFT predicts 14 % of the response to IVB in the same eye [R² = 9.6 %, p-value = 0.018]. When combined in a multi-factorial model, 33 % of the change in CSFT following IVB may be explained by these two factors. Lens status, change in visual acuity, and age were not statistically significant predictors of response.

Conclusions: In DME, the response to IVB in an eye is partially explained by the pre-injection retinal thickness in the same eye and by the response to IVB in the previously treated fellow eye. Lens status, change in visual acuity, and age were not statistically significant predictors of response in this study.

Citing Articles

Subthreshold Photocoagulation Using Endpoint Management in the PASCAL® System for Diffuse Diabetic Macular Edema.

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PMID: 29651345 PMC: 5831979. DOI: 10.1155/2018/7465794.

Short-term effects of intravitreal ranibizumab therapy on diabetic macular edema.

Minami Y, Nagaoka T, Ishibazawa A, Yoshida A BMC Ophthalmol. 2017; 17(1):28.

PMID: 28292270 PMC: 5351159. DOI: 10.1186/s12886-017-0420-8.

References

Wu Z, Sadda S . Effects on the contralateral eye after intravitreal bevacizumab and ranibizumab injections: a case report. Ann Acad Med Singap. 2008; 37(7):591-3. View

Sawada O, Kawamura H, Kakinoki M, Ohji M . Vascular endothelial growth factor in fellow eyes of eyes injected with intravitreal bevacizumab. Graefes Arch Clin Exp Ophthalmol. 2008; 246(10):1379-81. DOI: 10.1007/s00417-008-0874-8. View

Klein R, Klein B, Moss S, Davis M, DeMets D . The Wisconsin epidemiologic study of diabetic retinopathy. III. Prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years. Arch Ophthalmol. 1984; 102(4):527-32. DOI: 10.1001/archopht.1984.01040030405011. View

Klein R, Klein B, Moss S, Davis M, DeMets D . The Wisconsin epidemiologic study of diabetic retinopathy. IV. Diabetic macular edema. Ophthalmology. 1984; 91(12):1464-74. DOI: 10.1016/s0161-6420(84)34102-1. View

Kim M, Lee P, Kim Y, Yu S, Kwak H . Effect of intravitreal bevacizumab based on optical coherence tomography patterns of diabetic macular edema. Ophthalmologica. 2011; 226(3):138-44. DOI: 10.1159/000330045. View

Roh M, Kim J, Kwon O . Features of optical coherence tomography are predictive of visual outcomes after intravitreal bevacizumab injection for diabetic macular edema. Ophthalmologica. 2010; 224(6):374-80. DOI: 10.1159/000313820. View

Pelosini L, Hull C, Boyce J, McHugh D, Stanford M, Marshall J . Optical coherence tomography may be used to predict visual acuity in patients with macular edema. Invest Ophthalmol Vis Sci. 2010; 52(5):2741-8. DOI: 10.1167/iovs.09-4493. View

Wu P, Lai C, Chen C, Kuo C . Optical coherence tomographic patterns in diabetic macula edema can predict the effects of intravitreal bevacizumab injection as primary treatment. J Ocul Pharmacol Ther. 2011; 28(1):59-64. DOI: 10.1089/jop.2011.0070. View

Avery R, Pearlman J, Pieramici D, Rabena M, Castellarin A, Nasir M . Intravitreal bevacizumab (Avastin) in the treatment of proliferative diabetic retinopathy. Ophthalmology. 2006; 113(10):1695.e1-15. DOI: 10.1016/j.ophtha.2006.05.064. View

10.

Nguyen Q, Brown D, Marcus D, Boyer D, Patel S, Feiner L . Ranibizumab for diabetic macular edema: results from 2 phase III randomized trials: RISE and RIDE. Ophthalmology. 2012; 119(4):789-801. DOI: 10.1016/j.ophtha.2011.12.039. View

11.

Bakri S, Snyder M, Reid J, Pulido J, Singh R . Pharmacokinetics of intravitreal bevacizumab (Avastin). Ophthalmology. 2007; 114(5):855-9. DOI: 10.1016/j.ophtha.2007.01.017. View

12.

Scott I, Edwards A, Beck R, Bressler N, Chan C, Elman M . A phase II randomized clinical trial of intravitreal bevacizumab for diabetic macular edema. Ophthalmology. 2007; 114(10):1860-7. PMC: 2245885. DOI: 10.1016/j.ophtha.2007.05.062. View

13.

Moss S, Klein R, Klein B . Ten-year incidence of visual loss in a diabetic population. Ophthalmology. 1994; 101(6):1061-70. DOI: 10.1016/s0161-6420(94)31217-6. View

14.

Massin P, Bandello F, Garweg J, Hansen L, Harding S, Larsen M . Safety and efficacy of ranibizumab in diabetic macular edema (RESOLVE Study): a 12-month, randomized, controlled, double-masked, multicenter phase II study. Diabetes Care. 2010; 33(11):2399-405. PMC: 2963502. DOI: 10.2337/dc10-0493. View

15.

Meyer C, Krohne T, Holz F . Concentrations of unbound bevacizumab in the aqueous of untreated fellow eyes after a single intravitreal injection in humans. Acta Ophthalmol. 2010; 90(1):68-70. DOI: 10.1111/j.1755-3768.2009.01842.x. View

16.

Al-Dhibi H, Khan A . Bilateral response following unilateral intravitreal bevacizumab injection in a child with uveitic cystoid macular edema. J AAPOS. 2009; 13(4):400-2. DOI: 10.1016/j.jaapos.2009.03.006. View

17.

Shima C, Sakaguchi H, Gomi F, Kamei M, Ikuno Y, Oshima Y . Complications in patients after intravitreal injection of bevacizumab. Acta Ophthalmol. 2007; 86(4):372-6. DOI: 10.1111/j.1600-0420.2007.01067.x. View