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KMID : 0360220130540091445
Journal of the Korean Ophthalmological Society
2013 Volume.54 No. 9 p.1445 ~ p.1451
Two Cases of Long-Term Changes in the Retinal Nerve Fiber Layer Thickness after Intravitreal Bevacizumab for Diabetic Papillopathy
Kim Jong-Jin

Im Jong-Chan
Shin Jae-Pil
Kim In-Taek
Park Dong-Ho
Abstract
Purpose: To report long-term changes in the average retinal nerve fiber layer (RNFL) thickness in 2 patients who had intravitreal bevacizumab (IVB) injection for diabetic papillopathy.

Case summary: A 36-year-old patient with diabetes complained of decreased visual acuity (20/200) in the right eye. The fundus examination showed optic disc swelling in both eyes. The average RNFL thickness based on optical coherence tomography (OCT) increased to 278 ¥ìm and Goldmann perimetry showed nasal visual field defect in the right eye. The IVB was injected into the right eye. Three weeks after the IVB injection, RNFL thickness decreased to 135 ¥ìm and visual acuity improved to 20/25 in the right eye. However, RNFL thickness increased from 126 to 207 ¥ìm and visual acuity decreased to 20/32 in the left eye. Thus, IVB was injected into the left eye. In week 3, RNFL thickness decreased to 147 ¥ìm and visual acuity improved to 20/20 in the left eye. At 12 months after IVB injection, RNFL thickness was 87 ¥ìm in the right eye and 109 ¥ìm in the left eye. A 57-year-old patient with diabetes complained of decreased visual acuity (20/200) and showed optic disc swelling in the right eye. The average RNFL thickness increased to 252 ¥ìm and Goldmann perimetry showed an enlarged blind spot in the right eye. IVB was injected into the right eye. After 3 weeks, RNFL thickness decreased to 136 ¥ìm and visual acuity improved to 20/70 in the right eye. Six months after IVB injection, RNFL thickness was 83 ¥ìm in the right eye.

Conclusions: Visual acuity progressively improved within 3 weeks and RNFL thickness measured by spectral domain OCT showed progressive thickness reduction in 2 cases of diabetic papillopathy patients who had IVB injections.
KEYWORD
Bevacizumab, Diabetic papillopathy, Diabetic retinopathy, Retinal nerve fiber layer thickness
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