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

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]. 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. 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]. 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

25-gauge vitrectomy versus intravitreal bevacizumab for macular edema secondary to branch retinal vein occlusion: 1 year follow-up

<p><b>INTRODUCTION</b>This study aims to compare the long-term efficacy of 25-gauge vitrectomy to that of intravitreal bevacizumab (IVB) for the treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO).</p><p><b>MATERIALS AND METHODS</b>The medical records of 46 eyes of 46 consecutive patients were reviewed. Twenty-seven eyes underwent 25-gauge vitrectomy (VIT Group) and 19 eyes received 1.25 mg of IVB (IVB Group). The best-corrected visual acuities (BCVAs) in logarithm of minimum angle resolution units and central macular thicknesses (CMTs) were evaluated before and 3, 6, and 12 months after the initial treatment.</p><p><b>RESULTS</b>There was no significant difference in the pre-treatment BCVA and CMT between the 2 groups. In the VIT Group, the preoperative BCVA was 0.59 and the CMT was 587.3 μm and the BCVA was 0.35 and the CMT was 286.6 μm, 12 months after the vitrectomy. Both values were significantly (P <0.05) better at 12 months than the preoperative values. In the IVB Group, the average number of IVB was 2.4 during the 1-year period. The BCVA was 0.69 and the CMT was 590.9 μm before the IVB, and the BCVA was 0.36 and the CMT was 360.1 μm, 12 months after the initial IVB. The improvements of these 2 parameters were significant (P <0.05) at 12 months after the initial IVB. The differences in the BCVA and CMT at 12 months between the 2 groups were not significant.</p><p><b>CONCLUSION</b>These results suggest that the 25-gauge vitrectomy and IVB have similar effects in improving the BCVA and CMT in eyes with ME secondary to BRVO. However, IVB often required several injections to preserve the improvement.</p>