Evaluation of Changes in Choroidal and Retinal Thickness after a Single Intravitreal Injection of Bevacizumab in Patients with Diabetic Macular Edema

Background: Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are currently the mainstay of management in center-involved diabetic macular edema (ci-DME). However, the role of the choroid in diabetic macular edema (DME) and the effect of these drugs on the choroid is not well-understood. The aim of the study was to evaluate the changes in choroidal and retinal thickness after a single intravitreal injection of bevacizumab in patients with ci-DME. Methodology: This was a prospective, observational, hospital-based study at a tertiary care center in South India. Patients with ci-DME in one or both eyes were recruited after obtaining informed consent. Choroidal and retinal thickness was measured using swept source optical coherence tomography at baseline and 2 weeks after a single intravitreal bevacizumab (IVB) injection in the study eye. Results: A total of 28 patients (56 eyes) were included. There was a statistically significant improvement in logMAR best-corrected visual acuity (0.44 ± 0.23 vs. 0.38 ± 0.22, P = 0.029), with a reduction in subfoveal choroidal thickness (295.05 ± 65.80 vs. 285.93 ± 71.84, P = 0.014) and central retinal thickness (445.64 ± 105.80 vs. 383.11 ± 103.91, P = 0.002) in the treated eye, 2 weeks after a single IVB. Conclusions: A single intravitreal injection of bevacizumab (IVB) resulted in a significant reduction in both choroidal and retinal thickness, translating to an improvement in vision in treated eyes with ci-DME as early as 2 weeks, which seems to be effective in combating the harmful consequences of VEGF overaction in both the choroid and retina in patients with DME.