Posterior Sub-tenon's Bevacizumab Injection in Diabetic Macular Edema; a Pilot Study

Overview

Journal Saudi J Ophthalmol

Specialty Ophthalmology

Date 2015 Nov 21

PMID 26586977

Citations 2

Authors

Khalil Ghasemi Falavarjani

Joobin Khadamy

Arezoo Karimi Moghaddam

Nasser Karimi

Mehdi Modarres

Affiliations

Soon will be listed here.

Abstract

Purpose: To evaluate the short-term results of sub-tenon's injection of bevacizumab in patients with clinically significant macular edema (CSME).

Methods: In this prospective non-comparative interventional case series, sub-tenon's injection of 2.5 mg/0.1 ml bevacizumab was performed for eyes with CSME. Macular thickness and best corrected visual acuity measurements were performed before and one month after injections.

Results: Nineteen eyes of twelve patients with a mean age of 59.8 ± 5.7 years were evaluated. Thirteen eyes (68.4%) had center-involving macular edema. No significant difference was observed between pre- and post-injection central subfield retinal thickness measurements (P = 0.3). Central subfield thickness measurements improved or remained unchanged in 13 eyes (68.4%). Baseline BCVA of 0.48 ± 0.35 LogMAR improved to 0.36 ± 0.26 LogMAR after injection (P = 0.01). Improvement of >2 lines in BCVA was found in 5 eyes (26.3%), and no eye lost >2 lines of BCVA. No complication associated with sub-tenon's injection was observed.

Conclusion: Sub-tenon's injection of bevacizumab resulted in significant short-term visual improvement in eyes with CSME. Retinal thickness changes were not significant.

Citing Articles

An Update on Strategies to Deliver Protein and Peptide Drugs to the Eye.

Boddu S, Acharya D, Hala V, Jani H, Pande S, Patel C ACS Omega. 2023; 8(39):35470-35498.

PMID: 37810716 PMC: 10552503. DOI: 10.1021/acsomega.3c02897.

Ocular delivery of proteins and peptides: Challenges and novel formulation approaches.

Mandal A, Pal D, Agrahari V, Trinh H, Joseph M, Mitra A Adv Drug Deliv Rev. 2018; 126:67-95.

PMID: 29339145 PMC: 5995646. DOI: 10.1016/j.addr.2018.01.008.

References

Foroutan A, Fariba B, Pejman B, Mahmoud J, Khalil G, Arash E . Perilimbal bevacizumab injection for interface neovascularization after deep anterior lamellar keratoplasty. Cornea. 2010; 29(11):1268-72. DOI: 10.1097/ICO.0b013e3181d92834. View

Solaiman K, Diab M, Abo-Elenin M . Intravitreal bevacizumab and/or macular photocoagulation as a primary treatment for diffuse diabetic macular edema. Retina. 2010; 30(10):1638-45. DOI: 10.1097/IAE.0b013e3181e1ed07. View

Leung C, Yim-Lui Cheung C, Weinreb R, Lee G, Lin D, Pang C . Comparison of macular thickness measurements between time domain and spectral domain optical coherence tomography. Invest Ophthalmol Vis Sci. 2008; 49(11):4893-7. DOI: 10.1167/iovs.07-1326. View

Falavarjani K, Khoshamadi A, Nilforushan N . Peripapillary nerve fiber layer thickness changes after macular photocoagulation for clinically significant diabetic macular edema. Saudi J Ophthalmol. 2015; 29(1):67-70. PMC: 4314565. DOI: 10.1016/j.sjopt.2014.10.002. View

Liang I, Chang Y, Lee T, Lin Y, Liu K . Treatment of myopic choroidal neovascularization with posterior sub-Tenon's bevacizumab injection (Avastin ®). Int Ophthalmol. 2014; 34(4):971-7. DOI: 10.1007/s10792-014-9907-y. View

Chew E, Strauber S, Beck R, Aiello L, Antoszyk A, Bressler N . Randomized trial of peribulbar triamcinolone acetonide with and without focal photocoagulation for mild diabetic macular edema: a pilot study. Ophthalmology. 2007; 114(6):1190-6. PMC: 2465806. DOI: 10.1016/j.ophtha.2007.02.010. View

Ryoo N, Lee E, Kim T . Regression of iris neovascularization after subconjunctival injection of bevacizumab. Korean J Ophthalmol. 2013; 27(4):299-303. PMC: 3730075. DOI: 10.3341/kjo.2013.27.4.299. 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

Raghava S, Hammond M, Kompella U . Periocular routes for retinal drug delivery. Expert Opin Drug Deliv. 2005; 1(1):99-114. PMC: 11864216. DOI: 10.1517/17425247.1.1.99. View

10.

. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Early Treatment Diabetic Retinopathy Study research group. Arch Ophthalmol. 1985; 103(12):1796-806. View

11.

Scott I, Danis R, Bressler S, Bressler N, Browning D, Qin H . Effect of focal/grid photocoagulation on visual acuity and retinal thickening in eyes with non-center-involved diabetic macular edema. Retina. 2009; 29(5):613-7. PMC: 2735881. DOI: 10.1097/IAE.0b013e3181a2c07a. View

12.

Nomoto H, Shiraga F, Kuno N, Kimura E, Fujii S, Shinomiya K . Pharmacokinetics of bevacizumab after topical, subconjunctival, and intravitreal administration in rabbits. Invest Ophthalmol Vis Sci. 2009; 50(10):4807-13. DOI: 10.1167/iovs.08-3148. View

13.

Ghasemi Falavarjani K, Nguyen Q . Adverse events and complications associated with intravitreal injection of anti-VEGF agents: a review of literature. Eye (Lond). 2013; 27(7):787-94. PMC: 3709385. DOI: 10.1038/eye.2013.107. View

14.

Ho A, Scott I, Kim S, Brown G, Brown M, Ip M . Anti-vascular endothelial growth factor pharmacotherapy for diabetic macular edema: a report by the American Academy of Ophthalmology. Ophthalmology. 2012; 119(10):2179-88. DOI: 10.1016/j.ophtha.2012.07.058. View

15.

Bakbak B, Ozturk B, Gonul S, Yilmaz M, Gedik S . Comparison of the effect of unilateral intravitreal bevacizumab and ranibizumab injection on diabetic macular edema of the fellow eye. J Ocul Pharmacol Ther. 2013; 29(8):728-32. DOI: 10.1089/jop.2013.0049. View

16.

Yalcinbayir O, Gelisken O, Kaderli B, Avci R . Intravitreal versus sub-tenon posterior triamcinolone injection in bilateral diffuse diabetic macular edema. Ophthalmologica. 2011; 225(4):222-7. DOI: 10.1159/000324714. View

17.

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

18.

Erdurmus M, Totan Y . Subconjunctival bevacizumab for corneal neovascularization. Graefes Arch Clin Exp Ophthalmol. 2007; 245(10):1577-9. DOI: 10.1007/s00417-007-0587-4. View

19.

Nunes S, Pereira I, Santos A, Bernardes R, Cunha-Vaz J . Central retinal thickness measured with HD-OCT shows a weak correlation with visual acuity in eyes with CSME. Br J Ophthalmol. 2010; 94(9):1201-4. DOI: 10.1136/bjo.2009.165662. View

20.

Unoki N, Nishijima K, Kita M, Suzuma K, Watanabe D, Oh H . Randomised controlled trial of posterior sub-Tenon triamcinolone as adjunct to panretinal photocoagulation for treatment of diabetic retinopathy. Br J Ophthalmol. 2009; 93(6):765-70. DOI: 10.1136/bjo.2008.152041. View