Document Detail


The effect of adjunctive intravitreal bevacizumab for preventing postvitrectomy hemorrhage in proliferative diabetic retinopathy.
MedLine Citation:
PMID:  21724263     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the effects of preoperative and intraoperative intravitreal bevacizumab (IVB) injection on the incidence of postoperative vitreous hemorrhage (VH) after vitrectomy for proliferative diabetic retinopathy (PDR).
DESIGN: Prospective, randomized, clinical trial.
PARTICIPANTS: One hundred seven eyes of 91 patients undergoing pars plana vitrectomy (PPV) for the management of PDR-related complications were enrolled.
METHODS: One hundred seven cases were assigned randomly to either group 1 (intravitreal 1.25 mg/0.05 ml bevacizumab injection 1 to 14 days before PPV), group 2 (intravitreal 1.25 mg/0.05 ml bevacizumab injection at the end of PPV), or group 3 (no IVB injection).
MAIN OUTCOME MEASURES: The primary outcome was the incidence of early (≤ 4 weeks) and late (> 4 weeks) recurrent VH. Secondary outcome measures were the initial time of vitreous clearing (ITVC) and best-corrected visual acuity (BCVA) at 6 months after surgery.
RESULTS: The incidences of early recurrent VH were 22.2%, 10.8%, and 32.4% in groups 1, 2, and 3, respectively (P = 0.087). A subgroup pairwise analysis showed significantly decreased early VH incidence in group 2 compared with that of group 3 (P = 0.026). The incidences of late recurrent VH were 11.1%, 16.2%, and 14.7% in groups 1, 2, and 3, respectively (P = 0.813). The ITVC in groups 1, 2, and 3 were 26.4 ± 42.5 days, 10.3 ± 8.2 days, and 25.2 ± 26.1 days, respectively. The ITVC was significantly shorter in group 2 compared with that in groups 1 and 3 (P = 0.045 and P = 0.015, respectively). The BCVA at 6 months after surgery did not differ significantly among the 3 groups (P = 0.418).
CONCLUSIONS: This study found no substantial evidence to support the adjunctive use of preoperative IVB to reduce postoperative recurrence of VH in vitrectomy for PDR. For select cases in which adjunctive IVB use is considered, intraoperative administration seems to be the better option for reducing postoperative VH.
FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Authors:
Jeeyun Ahn; Se Joon Woo; Hum Chung; Kyu Hyung Park
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2011-07-02
Journal Detail:
Title:  Ophthalmology     Volume:  118     ISSN:  1549-4713     ISO Abbreviation:  Ophthalmology     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-03     Completed Date:  2011-12-22     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2218-26     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Angiogenesis Inhibitors / administration & dosage*
Antibodies, Monoclonal, Humanized / administration & dosage*
Chemotherapy, Adjuvant
Diabetic Retinopathy / physiopathology,  surgery*
Female
Humans
Incidence
Intravitreal Injections
Male
Middle Aged
Postoperative Hemorrhage / prevention & control*
Prospective Studies
Vascular Endothelial Growth Factor A / antagonists & inhibitors
Visual Acuity / physiology
Vitrectomy*
Vitreous Hemorrhage / prevention & control*
Chemical
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Antibodies, Monoclonal, Humanized; 0/VEGFA protein, human; 0/Vascular Endothelial Growth Factor A; 2S9ZZM9Q9V/bevacizumab
Comments/Corrections
Comment In:
Ophthalmology. 2013 Jan;120(1):219-20   [PMID:  23283198 ]
Ophthalmology. 2013 Jan;120(1):220-1   [PMID:  23283199 ]

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