The Short-Term Efficacy of Biweekly Subconjunctival Bevacizumab in Diabetic Macular Edema

Abstract

Purpose: To assess the effectiveness of subconjunctival bevacizumab (SB) injection every 2 weeks (biweekly) for diabetic macular edema (DME). Materials and Methods: In this prospective, non-randomized study; patients with clinically significant DME, who had central macular thickness (CMT) >300 µm, were included. They received three consecutive subconjunctival injections of 0.2 ml (5 mg) bevacizumab in biweekly intervals. Macular measurements were obtained by spectral-domain optical coherence tomography. The changes in CMT, and volumes of foveal (central 1 mm), parafoveal (between 1-3 mm), and perifoveal (3-6 mm) areas were followed. Results: Totally, 35 eyes of 26 patients with DME were included in the study. Five eyes were treatment-naive and 30 eyes were treatment non-naive. The means of CMT were 440.82 ± 101.22 µm at baseline, 380.11 ± 79.76 µm at second week, 338.34 ± 69.24 µm at first month, and 330.46 ± 74.16 µm at second month. Best-corrected visual acuity (BCVA) at baseline and second month were 0.56 ± 0.38 Log MAR (20/80) and 0.38 ± 0.35 Log MAR (20/50), respectively. While CMT, foveal, parafoveal, and perifoveal volumes significantly decreased after SB injections, a significant improvement in BCVA was found (p < .01 for all). No significant ocular or systemic adverse events were observed. Conclusions: Subconjunctival injection of bevacizumab every 2 weeks appears to be beneficial in the treatment of DME and it may provide significant anatomic and visual improvement, without ocular or systemic side effects. © 2019, © 2019 Taylor & Francis Group, LLC.