J Korean Ophthalmol Soc.  2018 Apr;59(4):332-337. 10.3341/jkos.2018.59.4.332.

Microaneurysm Turnover after the Use of Dexamethasone and Bevacizumab to Treat Diabetic Macular Edema

• Kim ST
• Jeong WJ

• KMID: 2409681
• DOI: http://doi.org/10.3341/jkos.2018.59.4.332

Abstract

PURPOSE
To evaluate microaneurysm (MA) turnover and changes in central retinal thickness after intravitreal dexamethasone implantation or intravitreal bevacizumab injection to treat diabetic macular edema.
METHODS
Sixty eyes with diabetic macular edema were evaluated. In all, 30 eyes received intravitreal dexamethasone implants (group A) and 30 received bevacizumab injections (group B). All patients were followed-up at 3 and 6 months. MA formation, disappearance, and turnover (MA formation rate minus disappearance rate) were evaluated. When the disappearance rate was greater than the formation rate (so the turnover was ≤0), the microaneurysms were considered to have resolved. Central retinal thickness (CRT) was measured using optical coherence tomography at all visits.
RESULTS
In group A, MA turnover was 86.6% at 3 months and 53.3% at 6 months, and thus decreased slightly over time, but was not eliminated. In group B, MA turnover was 56.6% at 3 months and 13.3% at 6 months; the between-group difference was statistically significant (p = 0.014). CRT decreased in both groups, but significantly less so in group B 3 months after injection. However, no significant between-group difference was apparent 6 months after injection.
CONCLUSIONS
There were no significant between-group differences in either CRT or MA turnover 3 months after injection. However, at 6 months, dexamethasone implantation showed slightly better results than intravitreal bevacizumab injection. However, further research on long-term MA turnover is required.

Keyword

Bevacizumab; Central macular thickness; Dexamethasone; Microaneurysm turnover; Microaneurysm

MeSH Terms

Bevacizumab*
Dexamethasone*
Humans
Macular Edema*
Retinaldehyde
Tomography, Optical Coherence
Bevacizumab
Dexamethasone
Retinaldehyde

Figure

• 

  Figure 1. The Microaneurysm of pre-injectional state (A, B) and at 3 and 6 months post-injectional state (C, D and E, F). The yellow circle is in radius of optic disc and macula (A, C, E = dexamethasone implant) (B, D, F = bevacizumab injection).

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