Efficacy of adjuvant topical timolol–dorzolamide with intravitreal bevacizumab injection in diabetic macular edema: A contralateral eye study

Purpose: To assess the efficacy of adjuvant topical timolol–dorzolamide with intravitreal bevacizumab (IVB) injection on anatomic and functional results in eyes affected with diabetic macular edema (DME). Methods: In an interventional prospective contralateral pilot eye study at a third level referral academic facility, patients with bilateral DME who were treatment-naive were enrolled. Enrolled patients received a treatment plan of topical timolol–dorzolamide twice daily in the right eye. Three monthly bilateral IVB injections 1.25 mg/0.05 mL were also planned. Baseline central macular thickness (CMT) was measured by spectral-domain optical coherence tomography (SD-OCT), and clinical information such as best corrected visual acuity (BCVA) and intraocular pressure (IOP) were collected at enrollment and one month after the third injection. Results: Eleven patients (seven females) with DME were included. BCVA and CMT improved in both eyes and IOP decreased in the right eye but did not change in the left eye. In repeated measures ANOVA analysis, the decrease in CMT and improvement in BCVA were significant in the right eye. Conclusion: Our study suggested that adjuvant topical timolol–dorzolamide in combination with IVB may further reduce central macular thickness in eyes with DME. Keywords: Timolol, Dorzolamide, Intravitreal bevacizumab, Diabetic macular edema, Macular thickness, Visual acuity