Abstract
Background: In this study we observe the effect of anti-VEGF on structural changes in diabetic macular edema (DME). To assess the changes in contrast sensitivity and visual acuity before and after treatment with anti-VEGF in DME. Methods: This study was conducted at Aravind eye hospital, Mehdipatnam, Hyderabad in a period of 6 months. This study was approved by Institutional Ethics Committee (IEC), University of Hyderabad. Thirty subjects with DME(diabetic macular edema) participated in this study. Informed consent was obtained from all subjects. All the subjects underwent a thorough comprehensive examination which included detailed medical and ocular history, best corrected visual acuity, contrast sensitivity and optical coherence tomography. Visual acuity, contrast sensitivity , central foveal thickness were compared to baseline values between Ranibizumab and Bevacizumab. Results: A total of 48 eyes from 60 eyes met inclusion criteria. Mean age of the subjects was 61 ± 10.97 years. The mean duration of diabetes was 120 ± 66.33 months. Mean visual acuity measurement improved from 0.74logMAR at baseline to 0.36 log MAR (p=0.198) one week after injection further improved to 0.19 log MAR after two weeks. At two weeks, N=23(46%) of Bevacizumab subjects and N=27(54%) of Ranibizumab subjects contrast sensitivity acheived LogMAR 1.0 from its baseline LogMAR 0.30(p=.860) not statistically significant. Mean ± standard deviation baseline central foveal thickness (422±125) microns reduced to (339±109) microns after one week and two weeks (279±77,P=0.182) after treatment. Foveal thickness , visual acuity and contrast sensitivity were not significantly different at each time interval between the groups. Conclusion: Bevacizumab and Ranibizumab appears to have interchangeable effect of improving visual acuity, contrast sensitivity and reducing foveal thickness in the short-term period of treatment. Results of the study concluded that effect of Anti VEGF equally essential as well as effective in improvement in structural and functional changes . Further studies require to obtained positive results regarding improvement in contrast sensitivity .