Effectiveness of Three Loading Dose of Intravitreal Bevacizumab in Central Diabetic Macular Edema.

Purpose: To assess efficacy of three loading dose of bevacizumab in central diabetic macular edema. Materials and Methods: This retrospective study included 30 eyes of 23 patients who were given three loading doses of monthly intravitreal bevacizumab (1.25 mg/mL) for central DDME between February, 2019 and January, 2021. The study included treatment-naive eyes with best-corrected visual acuity (BCVA) ≥ least 5 letters at baseline. In all cases, central macular thickness (CMT) was measured using spectral-domain optical coherence tomography (SD-OCT: Spectralis, Heidelberg Engineering, Heidelberg, Germany). The BCVA was assessed using geometric chart at 4 meters. BCVA, CMT and intraocular pressure measurements as well as biomicroscopy and fundus examination were performed at each control visit. Primary efficacy outcome was visual acuity gain (in letters) and CMT reduction. Data were analyzed using Paired samples t test, ANOVA and Pearson's correlation analysis. Findings: Mean age was 59.0±8.1 years in the study population. Mean BCVA was 19.6±10.7 letters while mean CMT was 479.0±10.6 µm at baseline. The vision was improved to 22.8±10.1 letters (p=0.007) while mean CMT was decreased t0 453.9±137.9 µm (p=0.163) after first injection (Paired samples t test). The vision was improved to 25.1±9.4 letters (p=0.007) and mean CMT was decreased to 420.8±130.5 µm (p=0.016) after second injection; and 28.6±9.9 letters (p=0.000) and 393±146.0 µm (p=0.002) after third injection. The letter gain was 9 letters. It was found that ≥3 orders improvement was achieved in 9 eyes )30%) whereas 2 orders in 8 eyes (26.7%) and 1 order in 9 eyes (30.0%). There was no response or decreased vision in 4 eyes (13.3%). Conclusion: Treatment with three loading dose of monthly bevacizumab is an effective first-line treatment ensuring visual and anatomic improvement in DME. [ABSTRACT FROM AUTHOR]