Avastin® and other anti-VEGF inhibitors have been used for the treatment of wet macular degeneration for the past several years. It has been quite effective in the treatment of choroidal neovascularization as seen in ARMD. The intraocular injections are given as a series and are administered in the office.
The mainstay of treatment for diabetic macular edema has been laser photocoagulation. Basically, treating the macular area with laser may decrease the amount of swelling, or edema, that has developed as a result of the diabetic retinopathy. This may stabilize vision or may lead to improvement. Some cases can not be treated with laser or the laser does not work.
What is next? Over the past few years, intraocular injection of steroids has also been shown to effective for controlling diabetic macular edema. Kenalog®, or triamcinolone acetonide, has been injected with very good success in controlling and improving macular edema. It has been a useful adjunct when used in combination for treatment of the macular degeneration. The injections need to be repeated.
Avastin® is also used occasionally for diabetic macular edema. Early results are positive and studies are ongoing, but many retinal surgeons are already using bevacizumab for diabetes!
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist