One-Month Anatomical and Functional Response to Intravitreal Bevacizumab in Diabetic Macular Edema: A Retrospective Single-Arm Study in Padang, Indonesia

Abstract

Background: Intravitreal bevacizumab is the anti-vascular endothelial growth factor agent available for diabetic macular edema (DME) in most Indonesian public hospitals, but West Sumatran data are scarce.

Objective: We quantified the one-month response and bounded what these data support.

Methods: This was a re-analysis (STROBE) of the aggregate tabulations of a retrospective single-arm pre-post series of all eyes given bevacizumab 1.25 mg/0.05 mL for DME at Dr. M. Djamil General Hospital, Padang (January 2022 to December 2024). Central macular thickness (CMT) and Snellen acuity before and one month after injection were compared by exact McNemar test with Wilson 95% confidence intervals (CI); unidentified quantities were bounded by exhaustive enumeration rather than assumed.

Result: Fourteen eyes of 11 patients were analysed, and mean CMT fell from 527 to 318 μm (−40%; Glass's Δ 1.37). The anatomical paired table is identified: CMT reached 300 μm or less in 9 of 14 eyes (64.3%, 95% CI 38.8–83.7; exact McNemar P = 0.004), holding under complete clustering (worst case P = 0.031). The acuity transition table is not identified; across its four admissible forms the exact P spans 0.008 to 0.057, widening to 0.227 once clustering is added. Effect modification by glycaemic control was not identified (risk difference bounded only between −0.833 and +1.000 across 24 reconstructions), and no between-stratum difference is detectable at 80% power.

Conclusion: The anatomical benefit at one month is therefore large and robust, whereas the functional benefit is suggestive but not established, and the roles of diabetes duration and glycaemic control remain undetermined.