Effect of bevacizumab, which remain after withdrawal of the first dose/s from a single-use vial on diabetic macular edema

Mehmet Demir


Background: The objective of this study was to investigate the effect of bevacizumab remaining after withdrawal of the first dose/s from a single-use vial in diabetic macular edema (DME) secondary to diabetic retinopathy.

Methods: Patients were divided into four groups according to duration of storage of the single-use vial of bevacizumab in the refrigerator: Group 1 received IVB when the vial was first opened, and Groups 2, 3, and 4 received IVB after 3, 7, and 15 days, respectively, after the first dose or doses had been withdrawn with an insulin (27-gauge) needle from the single-use vial. The Wilcoxon test was used to compare the results in four groups. p<0.05 was considered as statistically significant.

Results: Mean age, mean glycosylated hemoglobin, severe of retinapathy and status of the lens were similar in all groups (p>0.05). Preinjection mean best corrected visual acuity (BCVA) was 0.41±0.2; 0.39±0.2; 0.39±0.2 and 0.34±0.2 logMAR Group 1, 2, 3 and 4, respectively. Preinjection mean central macular thickness (CMT) was 503±88; 502±99; 565±63 and 491±107 µm in Group 1, 2, 3 and 4, respectively. After injection mean BCVA was 0.30±0.16; 0.28±0.20; 0.29±0.19 and 0.25±0.20 logMAR and mean CMT was 321±75; 315±97; 360±83 and 279±82 in Group 1, 2, 3 and 4, respectively. The mean BCVA increased significantly, and CMT decreased significantly after injection in all groups. No observed serious ophthalmologic or systemic side effects.

Conclusion: Bevacizumab which remain in the single use vial after first dose/s is safe and effective for treatment of DME. These results are useful for poor countries.


Diabetic macular edema, Bevacizumab, Central macular thickness

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