| Summary: | Diabetic retinopathy (DR) and diabetic macular edema (DME) are microvascular complications of diabetes that are a leading cause of blindness in the diabetic population. DME -- which is swelling of the retina due to leakage of fluid from blood vessels within the macula, the central portion of the retina -- may occur at any time during the progression of DR. The goal of treatment is to preserve current visual acuity and reduce the chances of progression to visual loss. Successful laser treatment reduces moderate visual loss but has limited effects on improving visual acuity. Intravitreal injection of corticosteroids, such as triamcinolone acetate, may also moderately improve visual acuity, but these generally offer only short-term improvements in acuity in cases of DME refractory to laser treatment. Moreover, triamcinolone is not licensed by Health Canada for this indication. Ranibizumab is a recombinant humanized monoclonal immunoglobulin G1 antibody that binds to and inhibits the biologic activity of human vascular endothelial growth factor (VEGF). It is the only pharmacological therapy licensed in Canada for the treatment of DME. Bevacizumab (Avastin), also derived from a recombinant humanized monoclonal IgG1 antibody that inhibits VEGF, is used clinically in the treatment of DME, although it does not have a Notice of Compliance (NoC) from Health Canada for this indication. It is approved as an antineoplastic, not for the condition under consideration. This systematic review was undertaken to evaluate the effects of intravitreal bevacizumab for the treatment of diabetic macular edema
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