Early vitreous hemorrhage after vitrectomy with preoperative intravitreal bevacizumab for proliferative diabetic retinopathy.

Abstract

PURPOSE:

To evaluate the effect of preoperative intravitreal bevacizumab (IVB) on surgical procedures, visual prognosis, and postoperative complications, especially postoperative vitreous hemorrhage, in cases with proliferative diabetic retinopathy (PDR).

MATERIALS AND METHODS:

Seventy-one eyes of 54 consecutive patients (23 eyes of 18 women, 48 eyes of 36 men) were investigated in this study. Twenty-five eyes received IVB one to 30 days before the vitrectomy (Bevacizumab Group) and the other 46 eyes had the vitrectomy alone (Control Group). The surgical procedures, best-corrected visual acuities at baseline, 1, 3, and 6 months after the vitrectomy, and postoperative complications in the Bevacizumab Group were compared to the Control Group.

RESULTS:

The patients were significantly younger in the Bevacizumab Group compared to the Control Group (P = 0.008). The incidence of preoperative vitreous hemorrhage, tractional retinal detachment, and iris neovascularization was significantly higher in the Bevacizumab Group than in the Control Group (P = 0.017, 0.041, and 0.018, respectively). The surgical procedures performed and the visual acuity at all time points was not significantly different between groups (P > 0.05, all comparisons). The incidence of early (≤ 4 weeks) postoperative vitreous hemorrhage was significantly higher in the Bevacizumab Group (27%) than in the Control Group (7%; P = 0.027) although the rate of late (>4 weeks) postoperative vitreous hemorrhage was not significantly different between groups (P > 0.05).

CONCLUSION:

Vitrectomy with preoperative IVB may have no detrimental effect on surgical procedures and achieves the surgical outcomes for repair of PDR equal to vitrectomy alone despite the obvious selection bias of the patients in this study. However, special monitoring is highly recommended for early postoperative vitreous hemorrhage because bevacizumab in the vitreous may be washed out during vitrectomy.

• Authors: Tatsuhiko Sato, Shin-ichi Morita, Hajime Bando, Shigeru Sato, Toshihide Ikeda, Kazuyuki Emi
• Journal: Middle East African journal of ophthalmology (Middle East Afr J Ophthalmol) 2013 Jan-Mar Vol. 20 Issue 1 Pg. 51-5 ISSN: 0975-1599 [Electronic] India
• PMID: 23580852 (Publication Type: Journal Article)

Chemical References

• Angiogenesis Inhibitors
• Antibodies, Monoclonal, Humanized
• VEGFA protein, human
• Vascular Endothelial Growth Factor A
• Bevacizumab

Topics

• Adult
• Aged
• Angiogenesis Inhibitors (therapeutic use)
• Antibodies, Monoclonal, Humanized (therapeutic use)
• Bevacizumab
• Combined Modality Therapy
• Diabetic Retinopathy (drug therapy, physiopathology, surgery)
• Female
• Humans
• Intravitreal Injections
• Male
• Middle Aged
• Postoperative Complications
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Visual Acuity
• Vitrectomy
• Vitreous Hemorrhage (etiology)