Effectiveness of Intravitreal Bevacizumab (Avastin) Injection in Patients with Proliferative Diabetic Retinopathy

Background: Proliferative diabetic retinopathy (PDR) is a vision-threatening complication of diabetes mellitus. Intravitreal Bevacizumab (Avastin), an anti-VEGF agent, is widely used to regress retinal neovascularization.

Objective: To evaluate the effectiveness of intravitreal Bevacizumab injection among the patients with proliferative diabetic retinopathy.
Methods: This comparative cross-sectional study was conducted at the Department of Ophthalmology, Sheikh Fazilatunnesa Mujib Eye Hospital & Training Institute from July 2022 to December 2023. A total of 112 PDR patients were equally divided into controlled (n=56) and uncontrolled (n=56) diabetes groups. All patients received intravitreal Bevacizumab (1.25 mg) and were followed up at 1 day, 2 weeks, and 1 month. Treatment response was assessed by fundus fluorescein angiography and categorized as complete, partial, or no regression. Results: The mean duration of diabetes mellitus was significantly higher among uncontrolled diabetic patients compared to controlled diabetic patients (15.4±4.36 vs. 10.8±3.98 years; p=0.001). IDDM was more common in both groups; however, the distribution of diabetes type was not significantly associated with glycemic control status (p=0.315). On the 1st post-procedure day, all patients in both groups showed no response to treatment. At the 2nd week follow-up, 96.4% of controlled diabetic patients achieved complete regression and 3.6% showed partial regression, whereas among uncontrolled diabetic patients, 32.1% achieved complete regression, 48.2% showed partial regression, and 19.6% showed no response (p=0.001). Similar findings were observed at the 4thweek follow-up (p=0.001).
Conclusion: Intravitreal Bevacizumab (Avastin) injection was found to be effective in the treatment of proliferative diabetic retinopathy, particularly among patients with well-controlled diabetes mellitus