Intravitreal Bevacizumab vs. Combination of Intravitreal Bevacizumab plus Macular Photocoagulation in Clinically Significant Diabetic Macular Edema: 6 months Results of a Randomized Clinical Trial

Purpose: to compare the 6-months anatomic and best corrected visual acuity (bcva) responses after primary intravitreal bevacizumab (ivb; intravitreal avastin) and ivb plus macular photocoagulation (mpc) in diabetics with clinically significant macular edema (csme)methods: in this interventional randomized clinical trial (rct) 40 diabetics (80 eyes) with bilateral csme and non-proliferative diabetic retinopathy (npdr) or early proliferative diabetic retinopathy (pdr) underwent ivb in one eye (group a) and ivb plus mpc in the other eye (group a+mpc). the patients had a complete eye exam (including bcva, oct and fluorescein angiography (f/a)) at baseline and were re-examined every two months for 6 months bcva and oct indices and number of ivb injections were recorded. main outcome measures were number of ivb injections and changes in bcva and oct.results: in both groups, the mean bcva [(group a: 0.326±0.279 logmar±sd before treatment and 0.188±0.245 logmar±sd at 6 months), (group a+ mpc 0.409±0.332 logmar±sd baseline and 0.230±0.273 logmar±sd at 6 months)] and oct indices [(group a: 261±115 ì before treatment and 221±87 ì mean±sd at 6 months) , (group a+ mpc: 270±93 ì baseline and 225±80 ì mean±sd at 6 months)] improved at the final follow-up and these changes were statistically significant; however there was no significant difference between the two groups at baseline and the final visit at 6 months follow-up. there was also no statistically significant difference in number of ivb injections between the two groups (group a: 2.3±1.24 and group a± mpc: 2.49±1.09).conclusion: ivb injection is an effective modality of treatment in csme, but mpc appears to have no additive effect on it, at least in the first 6 months of treatment.