ABSTRACT
The paper tries to examine the effect of avastin on visual acuity in patients with Ischemic and non-ischemic diabetic macular edema which was estimated convenient, inexpensive, safe, and quick in contrast to laser or deep vitrectomy. In this clinical trial study, patients with clinically significant macular edema [CSMA] were subjected to fluorescein angiography [FA] and people whose foveal avascular zones [FAZ] were over 1000 micro m were defined as ischemic diabetic macular edema. Patients were divided into two ischemic and non-ischemic groups. The best corrected visual acuity [BCVA] and the central macular thickness [CMT] in all eyes were measured and recorded by optical coherence tomography [OCT]. All patients received 3 vitreous injections of bevacizumab [avastin] at 1-month intervals. One month after the third injection, BCVA and CMT were measured again and patient's information was compared before and after the injection. Out of 87 eyes [66 patients], 23 eyes [26.4%] belonged to ischemic group and 64 eyes [73.6%] belonged to non-ischemic group. In ischemic group, BCVA improved from 0.653 +/- 0.309 LogMAR to 0.404 +/- 0.255 LogMAR [p=0.001], while no significant change was seen in non-ischemic group [from 0.881 +/- 0.332 to 0.879 +/- 0.378]. In ischemic group, CMT was increased from 362.9 +/- 34.66 to 278.76 +/- 45.57 and in non-ischemic group it was enhanced from 353.47 +/- 67.61 to 239.87 +/- 55.44 [p=0.001]. In spite of the great impact of vitreous injection of avastin in reducing the central macular thickness in both ischemic and non-ischemic groups and sensible improvement of patients' visibility, the visibility itself was not improved considerably in ischemic group