Anti-VEGF (vascular endothelial growth factor) drugs in diabetic macular oedema.

摘要: Sir, I read the article by Forte et al1 with interest. I congratulate authors for evaluating different treatment options in diabetic macular oedema (DME). I would like to comment about of DME intravitreal bevacizumab (IVB) alone. The half-life IVB vitreous cavity a rabbit eye has been shown be 4.32 days.2 Most in-vivo studies have that either plateaus or decreases thickness most eyes between 3–6 weeks. This demands need repeat injections. According Parravano al,3 multiple only short-term benefit anti-VEGF (vascular endothelial growth factor) drugs as compared present modalities. There is no sufficient high-quality evidence from large randomized controlled trials supporting use single injections treat DME. The systemic safety not yet established. Bevacizumab potential inhibit important physiological functions VEGF, such wound healing and development collaterals deemed significant myocardial peripheral ischaemia, thus potentially causing adverse events.4 Regarding steroid an adjunct also temporary effect on oedema, long-term visual acuity, but being associated side effects. any additional over laser photocoagulation.5 In conclusion, can used gross benefit, reduce thickness, followed focal grid give sustained response. Macular photocoagulation still gold-standard treatment. Multi-centre are needed compare alone combination DME, assess safety, number maintenance effect, risk.