Khalid Iqra, Malik Tayyaba Gul, Tariq Hassan, Sajid Usman
Dr. Iqra Khalid PGR Ophthalmology, Eye Unit-I, Lahore General Hospital, Lahore, Pakistan.
Prof. Tayyaba Gul Malik Head of Ophthalmology Department, Lahore General Hospital, Lahore, Pakistan.
Pak J Med Sci. 2025 Feb;41(2):355-358. doi: 10.12669/pjms.41.2.10289.
Intravitreal injections of Bevacizumab are widely used all over the world to treat Diabetic Retinopathy. However, there are thromboembolic events reported with its use. As blood coagulation is related with thromboembolism, the purpose of this study was to determine the effect of intravitreal injection of Bevacizumab on the coagulation profile of diabetic patients.
It was a quasi-experimental study, conducted at Department of Ophthalmology, Lahore General Hospital from January 2023 to August 2023. Patients with treatment naïve proliferative DR and diabetic macular edema were included and those with renal disease, hypertensive retinopathy, chronic liver disease, ischemic heart disease, previous history of stroke, retinal vascular occlusion, any malignancy, history of using anti coagulants and aspirin and the patients who lost to follow up and did not complete the blood work up after injection were excluded. Patients' Prothrombin time, bleeding time, clotting time, international normalized ratio and activated partial thromboplastin time were checked before and one week after intravitreal injection of Bevacizumab. Paired t test was used for analysis and p < 0.05 was set for significance.
There were 138 patients who fulfilled the inclusion criteria (92 males and 46 females). The mean age was 55±8 years. There was statistically insignificant difference between the coagulation profile before and after intravitreal injection of Bevacizumab.
Coagulation profile is not affected after one intravitreal injection of Bevacizumab. Other factors must be taken into account while injecting Bevacizumab in patients with history of thromboembolic events.
玻璃体内注射贝伐单抗在全球被广泛用于治疗糖尿病性视网膜病变。然而，有报道称其使用会引发血栓栓塞事件。由于血液凝固与血栓栓塞相关，本研究的目的是确定玻璃体内注射贝伐单抗对糖尿病患者凝血指标的影响。
这是一项准实验研究，于2023年1月至2023年8月在拉合尔综合医院眼科进行。纳入初治的增殖性糖尿病视网膜病变和糖尿病性黄斑水肿患者，排除患有肾脏疾病、高血压性视网膜病变、慢性肝病、缺血性心脏病、既往中风史、视网膜血管阻塞、任何恶性肿瘤、使用抗凝剂和阿司匹林史的患者，以及注射后失访且未完成血液检查的患者。在玻璃体内注射贝伐单抗前及注射后一周检查患者的凝血酶原时间、出血时间、凝血时间、国际标准化比值和活化部分凝血活酶时间。采用配对t检验进行分析，设定p<0.05为有统计学意义。
有138名患者符合纳入标准（92名男性和46名女性）。平均年龄为55±8岁。玻璃体内注射贝伐单抗前后的凝血指标差异无统计学意义。
单次玻璃体内注射贝伐单抗后凝血指标不受影响。对于有血栓栓塞事件史的患者，在注射贝伐单抗时必须考虑其他因素。
