Abstract
Intravitreal Bevacizumab (Avastin, Genentech Inc., San Francisco, CA) (IVB) has been shown to cause regression of neovessels in proliferative diabetic retinopathy due to its anti-angiogenic effects. This study was performed to investigate the role of Avastin as an adjunct to the management of patients with proliferative diabetic retinopathy undergoing pars plana vitrectomy. Fifty four eyes of 54 patients with proliferative diabetic retinopathy scheduled for surgery were included in the study. They were randomized to vitrectomy with preoperative IVB (group one) or standard vitrectomy (group 2). Group one underwent a single intravitreal injection of bevacizumab 1.25 mg /0.05ml one week prior to vitrectomy. Main outcome measures were best corrected visual acuity (BCVA) after surgery, post-operative complications. Mean age of the patients was 52.07±5.54 years (range 39-67). At 6 months, 20 patients in group one had BCVA better than baseline as compared to 12 patients in group 2. In group one, only one patient had early post-operative vitreous hemorrhage, whereas 11 patients in group two had early vitreous hemorrhage. Preoperative IVB is helpful in improving BCVA post operatively, reducing the time of surgery, decreasing the incidence of intraoperative and postoperative bleeding and reducing the frequency of rubeosis and hyphaema.
Highlights
The aim of vitrectomy in proliferative diabetic retinopathy is to re-establish visual acuity through removal of vitreous blood, removal of fibrovascular proliferation causing traction and to stabilize1
best corrected visual acuity (BCVA) before the surgery was noted on proforma and it was compared with the BCVA post operatively, change in BCVA was observed as either improvement, deterioration or no change
The difference in both groups was statistically significant with p value of less than 0.05, using independent t test. This prospective study was conducted to investigate the effect of Intravitreal bevacizumab (IVB) on diabetic vitrectomy
Summary
The aim of vitrectomy in proliferative diabetic retinopathy is to re-establish visual acuity through removal of vitreous blood, removal of fibrovascular proliferation causing traction and to stabilize1. The aim of vitrectomy in proliferative diabetic retinopathy is to re-establish visual acuity through removal of vitreous blood, removal of fibrovascular proliferation causing traction and to stabilize. Dr Abdul Fattah Memon, FCPS, 1-3: Al-Ibrahim Eye Hospital, Isra Post Graduate Institute of Ophthalmology, Karachi, Pakistan. October 11, 2012 December 4, 2012 December 26, 2012 January 3, 2013 the neovascular process through panretinal endophotocoagulation of ischemic retina. Intravitreal bevacizumab (IVB) has been shown to effectively reduce rubeosis and retinal neovascularization in proliferative diabetic retinopathy (PDR).[1,2] administration of IVB prior to diabetic vitrectomy may reduce intraoperative bleeding and post-operative complications in patients with tractional retinal detachment (TRD).[3] Recurrent vitreous hemorrhage is a common indication for reoperation. Most of the hemorrhages occurs during the first 6 months but may occur years later.[4]
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