Warda Ali1, Kanwal Zareen Abbasi2, Ali Raza3. 1. Department of Eye, Shifa College of Medicine / Shifa Tameer-e-Millat University, Islamabad, Pakistan. 2. Department of Eye, Benazir Bhutto Hospital, Rawalpindi, Pakistan. 3. Department of Eye, RMC and Allied Hospitals Rawalpindi, Pakistan.
Abstract
OBJECTIVE: To compare panretinal photocoagulation (PRP) plus intravitreal bevacizumab (IVB) against PRP alone in the treatment of proliferative diabetic retinopathy (PDR) in terms of mean change in best corrected visual acuity (BCVA), neovessels on disc (NVD) and neovessels elsewhere (NVE). STUDY DESIGN: Experimental study. PLACE AND DURATION OF STUDY: Department of Ophthalmology, Benazir Bhutto Hospital, Rawalpindi, from December 2014 to July 2015. METHODOLOGY:Sixty eyes were randomized into two groups with 30 eyes in each. In group A, IVB was given 15 days prior to PRP but in group B only PRP was given. In both groups, BCVA and neovessels status at disc and elsewhere was assessed before and at day 30. NVDs were judged as per percentage of NVD occupying surface of the disc (DD%). NVE were also judged as per reference to diameter of disc surface. RESULTS: The mean age of the study patients was 52.27 ±6.7 years. Mean BCVA (logMAR) in the PRP plus IVB group improved considerably from mean 0.64 ±0.17 to mean 0.49 ±0.21 at 30th day. However, in PRP group, there was no significant change in BCVA 0.64 ±0.16 at baseline to 0.63 ±0.18 at day 30. There were extremely significant changes between the two groups at 4th week (p<0.001). Mean NVE at baseline in PRP plus group was 3.30 ±0.95% at baseline that changes to 1.50 ±1.06% at day 30. While in only PRP group, mean NVE was 3.33 ±0.7% at baseline and 3.17 ±0.7% at one month of follow-up. In PRP plus group, NVD changes from mean 31.27 ±9.8% at baseline to 11.40 ±5.5% at one month of follow-up. In only PRP group, NVD changes from mean 31.13 ±10.23% at baseline to 29.53 ±11.04% at 1 month of follow-up. There were extremely significant changes between two groups at day 30 (p<0.001). CONCLUSION:Intravitreal bevacizumab in short duration is effective as adjunctive treatment to PRP with early and greater rate of regression of retinal neovessel than PRP alone in PDR patients.
RCT Entities:
OBJECTIVE: To compare panretinal photocoagulation (PRP) plus intravitreal bevacizumab (IVB) against PRP alone in the treatment of proliferative diabetic retinopathy (PDR) in terms of mean change in best corrected visual acuity (BCVA), neovessels on disc (NVD) and neovessels elsewhere (NVE). STUDY DESIGN: Experimental study. PLACE AND DURATION OF STUDY: Department of Ophthalmology, Benazir Bhutto Hospital, Rawalpindi, from December 2014 to July 2015. METHODOLOGY: Sixty eyes were randomized into two groups with 30 eyes in each. In group A, IVB was given 15 days prior to PRP but in group B only PRP was given. In both groups, BCVA and neovessels status at disc and elsewhere was assessed before and at day 30. NVDs were judged as per percentage of NVD occupying surface of the disc (DD%). NVE were also judged as per reference to diameter of disc surface. RESULTS: The mean age of the study patients was 52.27 ±6.7 years. Mean BCVA (logMAR) in the PRP plus IVB group improved considerably from mean 0.64 ±0.17 to mean 0.49 ±0.21 at 30th day. However, in PRP group, there was no significant change in BCVA 0.64 ±0.16 at baseline to 0.63 ±0.18 at day 30. There were extremely significant changes between the two groups at 4th week (p<0.001). Mean NVE at baseline in PRP plus group was 3.30 ±0.95% at baseline that changes to 1.50 ±1.06% at day 30. While in only PRP group, mean NVE was 3.33 ±0.7% at baseline and 3.17 ±0.7% at one month of follow-up. In PRP plus group, NVD changes from mean 31.27 ±9.8% at baseline to 11.40 ±5.5% at one month of follow-up. In only PRP group, NVD changes from mean 31.13 ±10.23% at baseline to 29.53 ±11.04% at 1 month of follow-up. There were extremely significant changes between two groups at day 30 (p<0.001). CONCLUSION: Intravitreal bevacizumab in short duration is effective as adjunctive treatment to PRP with early and greater rate of regression of retinal neovessel than PRP alone in PDR patients.