Short Term Outcome of Intravitreal Combination of Propranolol/ Bevacizumab versus Bevacizumab Alone in the Patients with Clinically Significant Macular Edema

Purpose: To evaluate the efficacy of intravitreal propranolol for the management of clinically significant macular edema (CSME) and assess whether it has an additive effect with intravitreal bevacizumab or not. Methods: We randomized 23 patients into 2 groups. The first group received 250μg/0.1ml intravitreal bevacizumab and in the other one 50μg /0.05ml, propranolol administered intravitreally in combination with 0.125μg/0.05ml bevacizumab. The response to the treatment was evaluated by measurement of BCVA and central macular thickness in the OCT. Results: Baseline BCVA was 0.62±0.31 in the group1 (who received the combination of Avastin and propranolol) and 0.45±0.14 in the group 2(which received only Avastin). The difference between the two groups was not significant (P=0.07). One month after injection, improvement of BCVA was not significant in both groups (0.07 log MAR ±0.18 in the 1st group, P=0.11 and 0.03±0.20 log MAR in the 2nd group=0.56). Baseline average CMT was 470±142.14 μm in the 1st group and 455.00±151.44 in the 2nd one. The difference between them was not markedly noticeable. One month after injection the value of CMT was significantly decreased in both groups (65.73±47.90 μm, P<0.001 in the 1st group and 69.46±83.14 in the latter one). there was no statistically remarkable difference between the two groups (P=0.88). Conclusion: This study showed no different effect in terms of reducing CMT and improvement of BCVA in the eyes treated with bevacizumab compared with the ones treated with a combination of bevacizumab and propranolol.