Anterior segment changes in nonproliferative diabetic patient with macular edema treated by intravitreous bevacizumab injection

非增殖性糖尿病合并黄斑水肿患者接受玻璃体内注射贝伐单抗治疗后,前节发生改变。

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Abstract

Currently, intravitreal bevacizumab is widely used for patients with intraocular neovascular disorders and macular edema. There are few studies about the effects of bevacizumab on anterior segment parameters and human cornea. The aim of this study was to evaluate the effects of intravitreal injection of bevacizumab on anterior chamber and central corneal thickness (CCT) during 3 months follow-up, using anterior segment optical coherence tomography. This longitudinal study was included 40 eyes of 20 patients. Patients received an intravitreal injection of 1.25 mg/0.05 mL bevacizumab. Anterior segment optical coherence tomography images were obtained and measurements were compared including angle opening distance and trabeculo-iris space area at 750 mm from the scleral spur, iris volume, anterior chamber volume, and CCT. Intraocular pressure (IOP) was also measured by Goldmann applanation tonometry. All parameters were measured before injection, 24 hours and 3 months after the last intravitreal injection. The mean age of patients was 61.38 ± 9.92 years. Ten patients (52.6%) were male. The mean number of injections was 3.3 ± 1.8. Anterior chamber volume, temporal and nasal angles of angle opening distance 750, and trabeculo-iris space area 750 were not significantly changed (P > .05). No significant difference was observed in mean IOP before injection and 24 hours and 3 months after injection (P = .84 and .08, respectively). The difference in mean of iris volume, before, 24 hours and 3 months after injection was significant (P value = .016). CCT was increased 24 hours and 3 months after injection compared to pre-injection (P = .008 and .03). Multiple intravitreal injections of bevacizumab significantly increased CCT 24 hours and 3 months after injection. Bevacizumab has also no significant effect on anterior chamber angle and IOP.

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