Effectiveness of Preoperative Intravitreal Bevacizumab Injections in Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy

PURPOSE: To evaluate the efficacy of preoperative intravitreal bevacizumab (Avastin(R); Genetech, San Francisco, CA, USA) injections of pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). METHODS: Thirty patients (30 eyes) who underwent PPV for treatment of PDR and received a preoperative intravitreal bevacizumab injection of 1.25 mg were retrospectively analyzed. The study group (group 1, 30 patients, 30 eyes) was compared with a control group (group 2, 29 patients, 30 eyes and matched with the study group for preoperative parameters) who underwent PPV without preoperative intravitreal bevacizumab injection. RESULTS: In both groups, visual acuity improved but there was no statistical significance. Intraoperative vitreous hemorrhage occurred in 14 eyes (46.7%) from group 1 and 11 eyes (36.7%) from group 2. There was no statistical significance of intraoperative bleeding occurrence (p=0.3). Postoperative vitreous hemorrhage occurred in 4 eyes from group 1 and 14 eyes from group 2. The group 1 had a lower incidence of postoperative hemorrhage than group 2 (p=0.005). CONCLUSIONS: Preoperative intravitreal bevacizumab injection appears effective in decreasing early postoperative vitreous hemorrhage and maybe technically helpful in PPV for PDR.

Effectiveness of Preoperative Intravitreal Bevacizumab Injections in Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy

PURPOSE: To evaluate the efficacy of preoperative intravitreal bevacizumab (Avastin(R); Genetech, San Francisco, CA, USA) injections of pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR). METHODS: Thirty patients (30 eyes) who underwent PPV for treatment of PDR and received a preoperative intravitreal bevacizumab injection of 1.25 mg were retrospectively analyzed. The study group (group 1, 30 patients, 30 eyes) was compared with a control group (group 2, 29 patients, 30 eyes and matched with the study group for preoperative parameters) who underwent PPV without preoperative intravitreal bevacizumab injection. RESULTS: In both groups, visual acuity improved but there was no statistical significance. Intraoperative vitreous hemorrhage occurred in 14 eyes (46.7%) from group 1 and 11 eyes (36.7%) from group 2. There was no statistical significance of intraoperative bleeding occurrence (p=0.3). Postoperative vitreous hemorrhage occurred in 4 eyes from group 1 and 14 eyes from group 2. The group 1 had a lower incidence of postoperative hemorrhage than group 2 (p=0.005). CONCLUSIONS: Preoperative intravitreal bevacizumab injection appears effective in decreasing early postoperative vitreous hemorrhage and maybe technically helpful in PPV for PDR.

Results of Intravitreal Bevacizumab for Macular Edema with Retinal Vein Occlusion and Diabetic Macular Edema

PURPOSE: To evaluate the short-term effect and safety of intravitreally injected bevacizumab in patients with macular edema (ME) caused by retinal vein occlusion (RVO) and diabetic macular edema (DME). METHODS: We retrospectively evaluated 59 eyes of 51 patients, 29 with ME caused by RVO and 30 with DME, who received intravitreal injection of bevacizumab. Fifty-one consecutive patients (59 eyes) with ME associated with RVO and DME were treated with intravitreal injections of 1.25-2.5 mg (0.05-0.1 ml) of bevacizumab. Ophthalmic evaluation was performed at baseline and at 1, 3, 6 months after each injection. Clinical evidence of toxicity and complications, changes of visual acuity with an ETDRS chart (LogMAR), and central macular thickness (CMT) using optical coherence tomography (OCT), were evaluated. RESULTS: The follow-up period was 7.3 months (7.3+/-0.31) and the mean number of injections was 1.2. The baseline mean LogMAR was 1.06+/-0.53 and mean CMT was 479.6+/-160.4 micrometer. At 1, 3 and 6 months, the mean LogMAR was 0.90+/-0.52, 0.80+/-0.39 and 0.78+/-0.39, respectively, and the mean CMT was 316.9+/-86.7 micrometer, 281.1+/-67.4 micrometer and 278.4+/-64.6 micrometer, respectively. No adverse incidents were observed, including cataract, retinal detachment, vitreous hemorrhage, and endophthalmitis, although transient increased intraocular pressure was observed. CONCLUSIONS: Intravitreal bevacizumab injections are safe and effective in ME caused by RVO and DME.

Two Cases of Subconjunctival Bevacizumab Injection to Prevent Bleb Failure After Trabeculectomy

PURPOSE: Angiogenesis is an integral part of wound healing, which is an unwanted process in the postoperative period after trabeculectomy. It was the aim of this study to report on the subconjunctival use of bevacizumab (Avastin(R)) as an antiproliferative agent to augment trabeculectomy. CASE SUMMARY: This clinical interventional case study included 2 patients with secondary glaucoma associated with uveitis who underwent antiglaucomatous filtering surgery combined with a subconjunctival injection of bevacizumab. Limbal-based trabeculectomy was performed, and subconjunctival injections (1.25 mg/0.05 ml) were given at the end of the surgery adjacent to the bleb, which was raised using a single-use 26 gauge needle. At 1 and 2 weeks and 1, 3, and 6 months after surgery, intraocular pressure was reduced in both patients to 11 mmHg with functioning filtering blebs. No complications were observed. CONCLUSIONS: The results suggest that subconjunctival bevacizumab injection may be helpful in reducing the risk of postoperative scarring of the filtering bleb.