IJRETINA (International Journal of Retina) (Sep 2021)
CENTRAL MACULAR THICKNESS AFTER COMBINED THERAPY OF BEVACIZUMAB INTRAVITREAL INJECTION AND TOPICAL DICLOFENAC COMPARED WITH BEVACIZUMAB INTRAVITREAL INJECTION ALONE IN DIABETIC MACULAR EDEMA
Abstract
Introduction: To evaluate whether the combination of diclofenac eye drops and bevacizumab intravitreal injection would provide additional benefits over bevacizumab alone in the treatment of naïve diabetic macular edema (DME). Methods: A total of 43 patients were enrolled consecutively and randomized into two groups to receive combination treatment with intravitreal bevacizumab and topical diclofenac (group 1) or bevacizumab alone (group 2). Group 1 patients received single bevacizumab intravitreal injection and got self-administered diclofenac eye drop four times daily for one month. Group 2 patients received single bevacizumab intravitreal injection alone. Outcome data were obtained from patient visits at baseline and at 1 month after bevacizumab intravitreal injection. All patients underwent measurement of best corrected visual acuity (BCVA), a complete eye examination, and measurement of central macular thickness (CMT). Result: The mean reduction in CMT in the combination group was 130.42±32.57 µm (p<0.01), while in the bevacizumab alone group the reduction was 141.38±45.27 µm (p<0.01), there is no significant difference between the two groups (p=0.866). The mean improvement of BCVA was 0.32±0.10 log Mar in the combination group and 0.26±0.12 in group 2, there is no significant difference between the two groups (p=0.691). There was no adverse ocular event in the two groups. Conclusion: In patients with naïve DME, adding diclofenac eye drop as adjuvant of bevacizumab intravitreal injection are less likely to have a meaningful effect on reducing the central macular thickness. Keywords: Diabetic macular edema, NSAID, diclofenac, anti-VEGF, bevacizumab, central macular thickness