Young Joo Park1, Jeeyun Ahn2, Tae Wan Kim3, Sang Jun Park4, Kwangsic Joo4, Kyu Hyung Park4, Joo Young Shin5. 1. Department of Ophthalmology, Kangwon National University Hospital, Chuncheon, South Korea. 2. SMG-SNU Boramae Medical Center, Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea. 3. SNU Blue Eye Clinic, Seoul, South Korea. 4. Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea. 5. SMG-SNU Boramae Medical Center, Department of Ophthalmology, Seoul National University College of Medicine, Seoul, South Korea. joo0shin@gmail.com.
Abstract
PURPOSE: To investigate the efficacy of intravitreal bevacizumab injections (IVBs) for vitreous haemorrhage (VH) in proliferative diabetic retinopathy (PDR) with prior complete panretinal photocoagulation (PRP). METHODS: A multicentre cohort study of eyes with new VH in PDR after documented previous complete PRP was performed. Eyes were grouped according to IVB treatment at baseline, and cumulative rate of vitrectomy and spontaneous clear-up rate were compared as the main outcome. Eyes requiring vitrectomy within 1 month, or with tractional retinal detachment (TRD), or with spontaneous clear-up within 1 month, were excluded. RESULTS: In total, 44 eyes with IVB and 92 control eyes without IVB were followed up to 20.1 months. Cumulative probability of vitrectomy was lower in the IVB group at 12 months (0.16 vs 0.42, IVB vs controls), and throughout the follow-up period (p = 0.005). Cumulative probability of spontaneous clear-up was higher in the IVB group at 12 months (0.81 vs 0.68, IVB vs controls), and throughout the follow-up period (p = 0.013). Best-corrected visual acuity (BCVA) at 1 month after onset of VH was significantly better in the IVB group (0.513 vs 0.942 logarithm of the minimal angle of resolution, p = 0.002); however, the difference of BCVA lost significance with further follow-up. IVB treatment was the only factor significantly associated with vitrectomy risk on multivariate analysis (p = 0.047, hazard ratio 0.506). CONCLUSION: In VH after prior complete PRP, IVB was effective in decreasing vitrectomy requirement, although overall visual benefit was short-term. IVB can be considered to defer vitrectomy in PDR VH eyes with prior complete PRP and no TRD.
PURPOSE: To investigate the efficacy of intravitreal bevacizumab injections (IVBs) for vitreous haemorrhage (VH) in proliferative diabetic retinopathy (PDR) with prior complete panretinal photocoagulation (PRP). METHODS: A multicentre cohort study of eyes with new VH in PDR after documented previous complete PRP was performed. Eyes were grouped according to IVB treatment at baseline, and cumulative rate of vitrectomy and spontaneous clear-up rate were compared as the main outcome. Eyes requiring vitrectomy within 1 month, or with tractional retinal detachment (TRD), or with spontaneous clear-up within 1 month, were excluded. RESULTS: In total, 44 eyes with IVB and 92 control eyes without IVB were followed up to 20.1 months. Cumulative probability of vitrectomy was lower in the IVB group at 12 months (0.16 vs 0.42, IVB vs controls), and throughout the follow-up period (p = 0.005). Cumulative probability of spontaneous clear-up was higher in the IVB group at 12 months (0.81 vs 0.68, IVB vs controls), and throughout the follow-up period (p = 0.013). Best-corrected visual acuity (BCVA) at 1 month after onset of VH was significantly better in the IVB group (0.513 vs 0.942 logarithm of the minimal angle of resolution, p = 0.002); however, the difference of BCVA lost significance with further follow-up. IVB treatment was the only factor significantly associated with vitrectomy risk on multivariate analysis (p = 0.047, hazard ratio 0.506). CONCLUSION: In VH after prior complete PRP, IVB was effective in decreasing vitrectomy requirement, although overall visual benefit was short-term. IVB can be considered to defer vitrectomy in PDR VH eyes with prior complete PRP and no TRD.