Bevacizumab Pretreatment in Vitrectomy With Silicone Oil for Severe Diabetic Retinopathy

Yeh, Po-Ting; Yang, Chung-May; Lin, Yu-Chi; Chen, Muh‐Shy; Yang, Chang‐Hao

doi:10.1097/iae.0b013e3181a3b7ef

Cited by 77 publications

(68 citation statements)

References 20 publications

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“…27 Multiple reports have also documented retinal tears and detachment induced by contraction of fibrovascular tissues after anti-VEGF injections in eyes with proliferative diabetic retinopathy. [28][29][30] Consistent with previous reports, [17][18][19] our study shows that the mean PED dimensions at baseline were significantly higher for eyes that developed RPE tears in comparison to those without RPE tears. In contrast, head-to-head comparison of baseline characteristics between 2.0 and 0.5 mg eyes failed to show significant differences (including PED dimensions) ( Table 1).…”

Section: Discussionsupporting

confidence: 82%

Earlier therapeutic effects associated with high dose (2.0 mg) Ranibizumab for treatment of vascularized pigment epithelial detachments in age-related macular degeneration

Chan

Abraham

Sarraf

et al. 2014

Eye

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Summary statement Intravitreal high dose (2 mg) ranibizumab may lead to quicker resolution of choroidal neovascularization (CNV) and associated retinal pigment epithelial detachment in eyes with exudative age-related macular degeneration, although it may possibly correlate with RPE tears in certain cases. Purpose This prospective study compared the outcomes of 0.5 vs 2.0 mg intravitreal ranibizumab injections (RI) for treating vascularized pigment epithelial detachment (vPED) due to age-related macular degeneration. Methods Patients with vPED were randomized to receive 2.0 vs 0.5 mg RI monthly for 12 months or for 4 months and then repeated on a pro-re nata basis. Optical coherence tomography, fundus photography, and fluorescein and indocyanine-green angiography were obtained at baseline and subsequent specific intervals. Outcome measures were best-corrected standardized visual acuities, central 1-mm thickness, surface area (SA), greatest linear diameter (GLD), heights (PED and CNV), and amount of subretinal fluid (SRF) and cystoid macular edema (CME). Results Both groups yielded reductions of the central 1-mm thickness, PED and CNV SA and PED height and GLD, SRF, and CME. Vision improvement and reduction in SRF and PED height occurred earlier for eyes receiving the 2.0 mg dose. Cataract progression was similar but RPE tears developed more often with the 2.0 mg dose. Conclusions There were similar visual and anatomical outcomes at the end of the study; however, the higher dose yielded more rapid reductions and more complete resolution of the PED, although there was possible increased tendency for an RPE tear with the higher dose.

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Section: Discussionsupporting

confidence: 82%

Earlier therapeutic effects associated with high dose (2.0 mg) Ranibizumab for treatment of vascularized pigment epithelial detachments in age-related macular degeneration

Chan

Abraham

Sarraf

et al. 2014

Eye

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“…[3][4][5] This facilitates segmentation and delamination of membranes, as they are less adhesive to the underlying retina and are more readily separated. 6 IVB has also been shown to decrease intraoperative haemorrhage. 7,8 This study investigated the outcomes of diabetic vitrectomy surgery in the Kilimanjaro Christian Medical Centre Eye Department in Tanzania, East Africa, before and after the introduction of previtrectomy IVB use.…”

Section: Introductionmentioning

confidence: 99%

Bevacizumab as an adjunct to vitreoretinal surgery for diabetic retinopathy in East Africa

Guthrie

Hall

Dhalla

et al. 2013

Eye

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Purpose The purpose of this study is to evaluate the efficacy of preoperative intravitreal bevacizumab (IVB) for improving outcomes in vitrectomy for diabetic retinopathy-related non-clearing vitreous haemorrhage and/or tractional retinal detachment. Methods Medical record from patients undergoing vitrectomy for proliferative diabetic retinopathy (PDR) were retrospectively analysed (2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011). From 2007, IVB (1.25 mg 2-4 days before operating) was used on all eyes. Eyes receiving IVB were compared with those that did not receive IVB. Intraoperative complications, reoperation rates, and final visual acuity were the core outcome measures. Results Data were analysed for 88 patients (101 eyes). In all, 41 (41%) patients had received IVB, whereas 60 (59%) patients had not. Significant intraoperative haemorrhage occurred in six eyes (10%) in the non-IVB group and in one (2.4%) IVB eyes (P ¼ 0.24). Silicon oil was used in 29 (48%) non-IVB eyes and in 11 (27%) IVB eyes (P ¼ 0.03). The non-IVB eyes underwent significantly more vitreoretinal reoperations (P ¼ 0.01) and were significantly more likely to lose two or more lines of vision at the final follow-up (P ¼ 0.03). The numbers needed to treat (NNT) blindness (o3/60) was four for non-IVB eyes and two for the IVB group. Conclusions IVB reduces surgical complications, the use of silicon oil, and the need for further retinal surgery. The NNT to restore useful vision (Z3/60) to a blind eye were significantly lower in the IVB group. Vitreoretinal surgery for the complications of PDR is effective in an East African context, and IVB should be considered a valuable adjunct.

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“…[2][3][4]8,9,62 There are several reports of development or progression of tractional retinal detachment (TRD) after intravitreal injection of bevacizumab before vitrectomy for advanced proliferative diabetic retinopathy (PDR). [63][64][65] In a retrospective series, 5.2% of eyes developed or had progression of TRD following injection. Time from injection to TRD was a mean of 13 days (range 3-31 days), and 9 out of 11 (81.8%) TRDs developed or progressed at 5 days or more after the injection.…”

Section: Adverse Events Following Intravitreal Anti-vegf Injections: mentioning

confidence: 99%

Adverse events and complications associated with intravitreal injection of anti-VEGF agents: a review of literature

Falavarjani

Nguyen

2013

Eye

736

505

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Intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents is increasingly used for the treatment of a wide variety of retinal diseases, including age-related macular degeneration, diabetic retinopathy and retinal vascular occlusions, and retinopathy of prematurity. Despite encouraging results in halting the disease and improving the vision, intravitreal injection of anti-VEGF agents may be associated with systemic adverse events and devastating ocular complications. In this review, we provide an overview of safety data for intravitreal injection of common anti-VEGF agents.

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Bevacizumab Pretreatment in Vitrectomy With Silicone Oil for Severe Diabetic Retinopathy

Abstract: Bevacizumab may reduce intra- and postoperative hemorrhage in diabetic vitrectomy with silicone oil infusion. Increased subretinal bleeding are potential complications.

Cited by 77 publications

References 20 publications

Earlier therapeutic effects associated with high dose (2.0 mg) Ranibizumab for treatment of vascularized pigment epithelial detachments in age-related macular degeneration

Earlier therapeutic effects associated with high dose (2.0 mg) Ranibizumab for treatment of vascularized pigment epithelial detachments in age-related macular degeneration

Bevacizumab as an adjunct to vitreoretinal surgery for diabetic retinopathy in East Africa

Adverse events and complications associated with intravitreal injection of anti-VEGF agents: a review of literature

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