AIM: To investigate patient assessed visual function and visual acuity after treatment with the unselective anti-VEGF inhibitor bevacizumab in diabetic macular edema after scatter laser photocoagulation due to proliferative diabetic retinopathy(PDR).METHODS: The case series of consecutive 30 eyes of 30 patients with PDR and persistent diabetic macular edema were treated with a single intravitreal dose of 1.25mg bevacizumab in 0.05mL (Avastin) in combination with scatter argon laser photocoagulation. The control group consisted of 30 eyes of 30 patients with PDR who received scatter laser photocoagulation alone. Main outcome measures were Snellen visual acuity,fundus clinical findings and patients self estimated quality of vision evaluated in scale of 0-100 percentages.RESULTS: Baseline visual acuity was mean 0.48±0.58 logMAR in the bevacizumab group and 0.61±0.78 (n.s.) in the control group. After 6 months,visual acuity hat not changed significantly to 0.33±0.41 and 0.52±0.68 in the bevacizumab and control group,respectively. Clinical examination showed only a trend to some improvement in macular edema. Subjective patient assessment of visual function on the visual analogue scale (VAS) showed an improvement from 60.2±17.5 to 76.0±15.6 (P<0.01) 6 months after the injection of bevacizumab. In the control group self-assessed visual function was mean 59.6±19.8,which did not differ from the baseline bevacizumab group (n.s.) but was high significantly (P<0.01) lower than after bevacizumab. CONCLUSION: Self-assessed visual acuity and patient satisfaction were significantly improved after intravitreal bevacizumab (Avastin) as additional therapy to scatter laser photocoagulation therapy for macular edema in PDR than after laser therapy alone. Visual acuity did not change significantly in this comparative case series over 6 months.KEYWORDS: proliferative diabetic retinopathy; visual acuity; self assessment; bevacizumab; scatter laser photocoagulation%目的:增生性糖尿病性视网膜病播散性视网膜激光光凝后,用非选择性抗VEGF抑制剂贝伐单抗治疗糖尿病性黄斑水肿,调查患者自我评估的视功能及视力.方法:30例30眼增生性糖尿病性视网膜病伴持续性糖尿病性黄斑水肿连续病例,播散性视网膜激光光凝后,1.25mg贝伐单抗0.05mL (Avastin)单剂量玻璃体腔注射治疗.对照组包括30例30眼增生性糖尿病性视网膜病,只接受播散性视网膜激光光凝.主要的调查结果包括Snellen视力,眼底临床检查和患者自我用0-100分数值范围评价的视觉质量.结果:贝伐单抗组的平均基线视力为0.48±0.58 logMAR,对照组为0.61±0.78 (两组无显著差异).6mo后,视力没有显著的变化,贝伐单抗组和对照组分别为0.33±0.41 和0.52±0.68.临床检查显示黄斑水肿仅有一些改善趋势.患者用直观模拟标度尺主观评价视功能结果显示注射贝伐单抗6mo后由60.2±17.5改善至76.0±15.6 (P<0.001).对照组自我评估视功能平均值为59.6±19.8,与贝伐单抗组基线值无显著差异,但是低于注射贝伐单抗后分数,差异有高度显著性(P<0.01).结论:治疗增生性糖尿病性视网膜病的黄斑水肿,贝伐单抗(Avastin)玻璃体腔注射作为播散性激光光凝的辅助治疗较单纯的激光治疗后患者满意度和自我评价的视力显著改善.患者视力在6mo后无明显变化.
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