The Change of Microaneurysm in Diabetic Retinopathy Patients Who Undergo Intravitreal Avastin (Bevacizumab) Injection

Chang Wook Choi; Seung Joon Lee; Hye Ra Kang; Yun Sik Yang

doi:10.3341/jkos.2014.55.10.1481

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Choi, Lee, Kang, and Yang: The Change of Microaneurysm in Diabetic Retinopathy Patients Who Undergo Intravitreal Avastin (Bevacizumab) Injection

Original Article

J Korean Ophthalmol Soc 2014;55(10):1481-1486.

Published online: 2 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.10.1481

The Change of Microaneurysm in Diabetic Retinopathy Patients Who Undergo Intravitreal Avastin (Bevacizumab) Injection

Chang Wook Choi, MD¹, Seung Joon Lee, MD¹, Hye Ra Kang, MD², Yun Sik Yang, MD, PhD^1,

¹Department of Ophthalmology, Wonkwang University School of Medicine & Hospital, Wonkwang University School of Medicine, Iksan, Korea

²Department of Ophthalmology, Presbyterian Medical Center, Jeonju, Korea

Address reprint requests to Yun Sik Yang, MD, PhD, Department of Ophthalmology, Wonkwang University School of Medicine & Hospital, #895 Muwang-ro, Iksan 570-711, Korea, Tel: 82-63-859-1382, Fax: 82-63-858-3922 E-mail: ysyang@wonkwang.ac.kr

Received 21 March 2014 Revised 19 June 2014 Accepted 17 September 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate microvascular change (microaneurysm) in diabetic retinopathy patients who undergo intravitreal bevacizumab injection using fluorescein angiography (FAG).

Methods

Thirty one eyes of 31 diabetic retinopathy patients undergoing intravitreal bevacizumab injection (1.25 mg/0.05 mL) in only 1 eye were included in this study. The control group (31 eyes) consisted of the fellow eyes. We excluded cased with intra-vitreal bevacizumab injection in both eyes and medial opacity obscuring three fundus image due to vitreous hemorrhage. The microaneurysmal change was analyzed at the same site the circle with optic disc radius and macula using FAG 2 to 4 months after injection.

Results

The average number of microaneurysms was 42.58 ± 33.93 and significantly decreased to 28.74 ± 28.06 after intra-vitreal bevacizumab injection (p < 0.05). The decrease of 35.70 ± 24.79% in the treatment group was statistically higher than 13.95 ± 38.21% in the control group with the fellow eyes (p < 0.05).

Conclusions

In the present study, intravitreal bevacizumab injection reduced neovascularization, cystoid macular edema. Therefore this data can be used for future research on microvascular changes in the retina.

Keywords: Bebacizumab (Avastin), Diabetic retinopathy, Vascular endothelial growth factor (VEGF)

References

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Figure 1.

Microaneurysm of preinjectional state (A, B) and at 8 week postinjectional state (C, D) after intravitreal bevacizumab injection. The circle with a radius of optic disc and macular (red line) (A, C = patients #24 in Fig. 2, 3) (B, D = patients #30 in Fig. 2, 3).

Figure 2.

The change of microaneurysm between pre intravitreous bevacizumab injection (IVB) and post IVB by fluorescein angiography (FAG).

Figure 3.

Comparison between intravitreous bevacizumab injection (IVB) group and control group in microaneurysm changes.

Table 1.

Characteristics of 31 patients who underwent intravitreal bevacizumab injection for diabetic retinopathy

Variable	Data
Total (eyes, %)
Male	14 (45.16)
Female	17 (54.84)
Age (years)
Mean ± SD	58.61 ± 8.34
Range	41-76
DM types (eyes, %)
Type 1	1 (3.23)
Type 2	30 (96.77)
DMR type (eyes, %)
NPDR	6 (19.35)
PDR	25 (80.65)
DM duration (years)
Mean ± SD	16.97 ± 9.39
Range	1-37
Preinjectional PRP state (eyes, %)
Yes	23 (74.19)
No	8 (25.81)
Lens status (eyes, %)
Phakia	23 (74.19)
Pseudophakia	8 (25.81)

SD = standard deviation; DM = diabetes Mellitus; DMR = diabetic retinopathy; NPDR = nonproliferative diabetic retinopathy; PDR = proliferative diabetic retinopathy; PRP = panretinal photocoagulation.

Table 2.

The changes of microaneurysms between pre IVB and post IVB by fluorescein angiography (FAG)

	Pre IVB	Post IVB	p-value
Microaneurysm count	42.58 ± 33.93	28.74 ± 28.06	0.000

Values are presented as mean ± SD.

IVB = intravitreous bevacizumab injection.

Table 3.

Comparison between IVB group and control group in microaneurysm changes

	IVB group	Control group	p-value
Microaneurysm change (%)	35.70 ± 24.79	13.95 ± 38.21	0.021

Values are presented as mean ± SD.

IVB = intravitreous bevacizumab.

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