Ferenchak Kevin, Duval Renaud, Cohen Jack A, MacCumber Mathew W
*Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois; and †Illinois Retina Associates, SC, Chicago, Illinois.
Retina. 2014 Jun;34(6):1177-81. doi: 10.1097/IAE.0000000000000058.
To describe the experience of authors using intravitreal bevacizumab (IVB) for eyes with recurrent vitreous hemorrhage (VH) after vitrectomy for proliferative diabetic retinopathy.
Chart review was performed on eligible eyes from the Illinois Retina Associates' patient database that had at least 6 months of follow-up after receiving IVB in the operative eye for recurrent VH after vitrectomy for proliferative diabetic retinopathy.
Twelve eyes of nine patients were included in the study and none required repeat vitrectomy for recurrent VH. Mean follow-up was 22 months (range, 8-42). A mean of 8.1 IVB (range, 1-18) were given. The mean number of recurrent VH was 4 (range, 2-8), and a mean of 3.5 of these VHs (range, 1-8) were clear at the appointment after an injection, typically in 4 to 6 weeks. Patients with history of multiple recurrent VH received prophylactic IVB, and repeated injections at regular intervals were associated with increased time period without recurrent VH.
Intravitreal bevacizumab was a safe and effective adjunct in this series for the management of recurrent VH after vitrectomy for proliferative diabetic retinopathy. No patients required repeat vitrectomy for recurrent VH, and prophylactic IVB was associated with longer periods of clear vitreous in the late postoperative period.
描述作者使用玻璃体内注射贝伐单抗(IVB)治疗增生性糖尿病视网膜病变玻璃体切除术后复发性玻璃体出血(VH)患者的经验。
对伊利诺伊视网膜协会患者数据库中符合条件的眼睛进行病历回顾,这些眼睛在接受IVB治疗增生性糖尿病视网膜病变玻璃体切除术后复发性VH的手术眼后至少随访6个月。
本研究纳入了9例患者的12只眼睛,无一例因复发性VH需要再次进行玻璃体切除术。平均随访时间为22个月(范围8 - 42个月)。平均给予8.1次IVB注射(范围1 - 18次)。复发性VH的平均次数为4次(范围2 - 8次),其中平均3.5次VH(范围1 - 8次)在注射后的随访预约时玻璃体腔清晰,通常在4至6周时。有多次复发性VH病史的患者接受了预防性IVB治疗,定期重复注射与无复发性VH的时间延长有关。
在本系列研究中,玻璃体内注射贝伐单抗是治疗增生性糖尿病视网膜病变玻璃体切除术后复发性VH的一种安全有效的辅助治疗方法。没有患者因复发性VH需要再次进行玻璃体切除术,预防性IVB治疗与术后晚期玻璃体腔较长时间保持清晰有关。