Literature DB >> 19039332

Can a preoperative bevacizumab injection prevent recurrent postvitrectomy diabetic vitreous haemorrhage?

M R Romano1, S K Gibran, J Marticorena, D Wong, H Heimann.   

Abstract

AIMS: To evaluate the recurrence rate of vitreous haemorrhage (VH) in patients treated with one intravitreal bevacizumab (IVB) injection (2.5 mg/0.1 ml) before planned pars plana vitrectomy for treatment of diabetic non-clearing VH.
METHODS: Prospective pilot study of 32 eyes of 31 consecutive diabetic patients who underwent IVB injection within 1 week before surgery for persistent VH in the presence of active proliferative diabetic retinopathy. Three masked retinal specialists graded the amount of VH from grade 0 to grade 3 with slit-lamp biomicroscopy. Main outcome measures were the rate of recurrence of the VH, improvement in visual acuity, incidence of cataract formation, and postoperative complications through a follow-up of 6 months.
RESULTS: The percentage of severe recurrent VH with no fundus details (grade 3) was 3% at 1 week follow-up and 3, 6, and 6% respectively at 1-, 3-, and 6-month follow-up. The mean best-corrected visual acuity (BCVA) improved from 1.6 (1/60) to 0.40 (6/15) logMAR (P=0.02) in 29 out of 32 eyes (91%). In all, 12 out of 22 (54%) phakic eyes developed cataract during the follow-up period, and 10 (31%) of them underwent cataract surgery.
CONCLUSIONS: Our study suggests that IVB injection few days before planned surgery seems to be efficacious and safe as an adjuvant treatment to prevent rebleeding in eyes undergoing pars plana vitrectomy for treatment of diabetic vitreous haemorrhage. IVB facilitates the surgery and reduces the need for extensive delamination and segmentation, decreasing the possibility of significant early active postoperative VH.

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Year:  2008        PMID: 19039332     DOI: 10.1038/eye.2008.354

Source DB:  PubMed          Journal:  Eye (Lond)        ISSN: 0950-222X            Impact factor:   3.775


  14 in total

1.  Intravitreal injection of bevacizumab and triamcinolone acetonide at the end of vitrectomy for diabetic vitreous hemorrhage: a comparative study.

Authors:  Dong Ho Park; Jae Pil Shin; Si Yeol Kim
Journal:  Graefes Arch Clin Exp Ophthalmol       Date:  2009-12-12       Impact factor: 3.117

2.  Bevacizumab prior to vitrectomy for diabetic traction retinal detachment.

Authors:  R Pokroy; U R Desai; E Du; Y Li; P Edwards
Journal:  Eye (Lond)       Date:  2011-07-08       Impact factor: 3.775

Review 3.  A review of clinical trials of anti-VEGF agents for diabetic retinopathy.

Authors:  Benjamin P Nicholson; Andrew P Schachat
Journal:  Graefes Arch Clin Exp Ophthalmol       Date:  2010-02-20       Impact factor: 3.117

4.  Six-month visual outcome after pars plana vitrectomy in proliferative diabetic retinopathy with or without a single preoperative injection of intravitreal bevacizumab.

Authors:  Amod Gupta; Reema Bansal; Vishali Gupta; Mangat R Dogra
Journal:  Int Ophthalmol       Date:  2012-03-27       Impact factor: 2.031

5.  Intravitreal bevacizumab for surgical treatment of severe proliferative diabetic retinopathy.

Authors:  Raffaello di Lauro; Pio De Ruggiero; Raffaella di Lauro; Maria Teresa di Lauro; Mario Rosario Romano
Journal:  Graefes Arch Clin Exp Ophthalmol       Date:  2010-02-05       Impact factor: 3.117

6.  Ranibizumab pretreatment in diabetic vitrectomy: a pilot randomised controlled trial (the RaDiVit study).

Authors:  O Comyn; L Wickham; D G Charteris; P M Sullivan; E Ezra; Z Gregor; G W Aylward; L da Cruz; D Fabinyi; T Peto; M Restori; W Xing; C Bunce; P G Hykin; J W Bainbridge
Journal:  Eye (Lond)       Date:  2017-05-12       Impact factor: 3.775

7.  Intravitreal Avastin as an adjunct in patients with proliferative diabetic retinopathy undergoing pars plana vitrectomy.

Authors:  Yawar Zaman; Aziz-Ur Rehman; Abdul Fattah Memon
Journal:  Pak J Med Sci       Date:  2013-04       Impact factor: 1.088

Review 8.  Surgical management of diabetic retinopathy.

Authors:  Vishali Gupta; J Fernando Arevalo
Journal:  Middle East Afr J Ophthalmol       Date:  2013 Oct-Dec

9.  Emerging roles for antiangiogenesis factors in management of ocular disease.

Authors:  Muhammad Usman Saeed; Evangelia Gkaragkani; Kashif Ali
Journal:  Clin Ophthalmol       Date:  2013-03-13

Review 10.  Anti-vascular endothelial growth factor for prevention of postoperative vitreous cavity haemorrhage after vitrectomy for proliferative diabetic retinopathy.

Authors:  Jonathan M Smith; David H W Steel
Journal:  Cochrane Database Syst Rev       Date:  2015-08-07
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