Effect of intravitreal injection of Bevacizumab for vitreous hemorrhage in patients with proliferative diabetic retinopathy

Abstract:

AIM:To study the effect of intravitreal injection of Bevacizumab for vitreous hemorrhage in patients with proliferative diabetic retinopathy(PDR).

METHODS:Fifty eyes in 46 PDR patients with vitreous hemorrhage were randomly divided into two groups. Thirty eyes in 28 patients were given intravitreal bevacizumab injection as the injection group. Twenty eyes in 18 patients were given the same treatment as injection group except bevacizumab injection in the control group. The absorption of vitreous hemorrhage, operation condition, best corrected visual acuity(BCVA), vitreous hemorrhage recurrence and other complications were observed. All the patients were followed up every week. If the hemorrhage was absorbed and the fundus could be seen clearly, the fundus fluorescein angiography(FFA)and laser photocoagulation were given. At 4wk after treatment, if the hemorrhage was not absorbed and became even worse, or retinal detachment occurred during the follow-ups, pars plana vitrectomy(PPV)would be taken. The follow-up time was 3mo.

RESULTS:Three months after intravitreal bevacizumab injection, the total number of the eyes avoiding vitrectomy was 10 eyes, 9 eyes(30%)in the injection group compared with 1 eye(5%)in the control group(χ²=6.108,P=0.0171). There were 19 eyes whose BCVA increased in the injection group, the proportion was 63%(19/30); there were 7 eyes whose BCVA increased in the control group,the proportion was 35%(7/20); there was statistically significant difference(χ²=6.102,P=0.014). The total number of the eyes receiving vitrectomy was 40, 5 eyes of 21(24%)were filled with silicone oil in the injection group, compared with 12 eyes of 19(63%)in the control group(χ²=5.2849, P=0.0137).

CONCLUSION:Intravitreous injection of bevacizumab for the PDR patients with vitreous hemorrhage can reduce the possibility of vitrectomy for some patients, reduce the difficulties of the vitrectomy for the others. The operation difficulty can be less and the use of silicon oil in the vitrectomy can be reduced. It is helpful in reducing the postoperative vitreous recurrent hemorrhage and improving the postoperative BCVA.