Dr. Yawar Zaman, FRCS, Al-Ibrahim Eye Hospital, Isra Post Graduate Institute of Ophthalmology, Karachi, Pakistan.
Dr.Aziz-ur-Rehman, FCPS, Al-Ibrahim Eye Hospital, Isra Post Graduate Institute of Ophthalmology, Karachi, Pakistan.
Pak J Med Sci. 2013 Apr;29(2):590-2. doi: 10.12669/pjms.292.3044.
Intravitreal Bevacizumab (Avastin, Genentech Inc., San Francisco, CA) (IVB) has been shown to cause regression of neovessels in proliferative diabetic retinopathy due to its anti-angiogenic effects. This study was performed to investigate the role of Avastin as an adjunct to the management of patients with proliferative diabetic retinopathy undergoing pars plana vitrectomy.
Fifty four eyes of 54 patients with proliferative diabetic retinopathy scheduled for surgery were included in the study. They were randomized to vitrectomy with preoperative IVB (group one) or standard vitrectomy (group 2). Group one underwent a single intravitreal injection of bevacizumab 1.25 mg /0.05ml one week prior to vitrectomy. Main outcome measures were best corrected visual acuity (BCVA) after surgery, post-operative complications.
Mean age of the patients was 52.07±5.54 years (range 39-67). At 6 months, 20 patients in group one had BCVA better than baseline as compared to 12 patients in group 2. In group one, only one patient had early post-operative vitreous hemorrhage, whereas 11 patients in group two had early vitreous hemorrhage.
Preoperative IVB is helpful in improving BCVA post operatively, reducing the time of surgery, decreasing the incidence of intraoperative and postoperative bleeding and reducing the frequency of rubeosis and hyphaema.
贝伐单抗(阿瓦斯汀,基因泰克公司,旧金山,加利福尼亚州)(IVB)已被证明可通过其抗血管生成作用使新生血管在增生性糖尿病性视网膜病变中消退。本研究旨在探讨阿瓦斯汀作为增生性糖尿病性视网膜病变患者行玻璃体切除术辅助治疗的作用。
54 只眼 54 例增生性糖尿病性视网膜病变患者纳入研究。他们被随机分为玻璃体切除术联合术前 IVB(一组)或标准玻璃体切除术(二组)。一组在玻璃体切除术前一周接受单次玻璃体内注射贝伐单抗 1.25 毫克/0.05 毫升。主要观察指标为手术后最佳矫正视力(BCVA)、术后并发症。
患者平均年龄为 52.07±5.54 岁(范围 39-67)。在 6 个月时,一组中有 20 例患者的 BCVA 优于基线,而二组中有 12 例患者。一组中只有 1 例患者发生早期术后玻璃体积血,而二组中有 11 例患者发生早期玻璃体积血。
术前 IVB 有助于改善术后 BCVA,减少手术时间,减少术中及术后出血的发生率,并减少新生血管和眼内炎的发生频率。