According to a study published Online First by Archives of Ophthalmology, bevacizumab appears to be more effective at treating diabetic macular edema (swelling of the retina) than macular laser therapy.

The researchers of the randomized controlled trial found that among participants with persistent clinically significant diabetic macular edema (CSME), bevacizumab showed to be effective at 12 months and was maintained through 24 months.

For the past 30 years, Modified Early Treatment Diabetic Retinopathy Study (ETDRS) macular laser therapy (MLT) has been the leading treatment for individuals suffering from CSME.

Although MLT lowers the risk of moderate visual loss, improved treatments have been sought as visual acuity only improves in less than 3% of patients (a 15-letter gain at 3 years).

Ranjan Rajendram, M.D., F.R.C.Ophth., of Moorfields Eye Hospital, London, and colleagues reveal the two-year outcomes of the BOLT Study.

The prospective randomized controlled trial involved 80 participants with CSME. Participants were randomly assigned to receive either injections into the eye (intravitreous bevacizumab) or modified ETDRS MLT.

The researchers found that at two years, the mean ETDRS best-corrected visual acuity in the bevacizumab group was 64.4 (Snellen visual acuity equivalent: 20/50) and 54.8 (Snellen equivalent: 20/80) in the MLT group.

Participants in the bevacizumab group gained a mean 8.6 letters, while participants in the MLT group lost a mean of 0.5 letters.

At 24 months, patients in the bevacizumab group gained a median of 9 ETDRS letters, compared with 2.5 ETDRS letters in the MLT group.

At two years, 49% of patients in the bevacizumab group gained 10+ ETDRS letters and 32 gained 15+ letters, versus participants in the MLT group 7% and 4%.

The researchers conclude:

“In conclusion, this investigator-initiated single-center study provides evidence for the longer-term use of bevacizumab in the treatment of persistent DME [diabetic macular edema].

Visual acuity benefit was maintained through two years with a reduced injection frequency in the second year despite the long duration of DME and multiple MLTs before entering the study. This finding will be reassuring to physicians charged with delivery of this relatively new treatment.”

Written By Grace Rattue