<p>Evaluation Of The Timing Of Intravitreal Bevacizumab Injection As Adjuvant Therapy To Panretinal Photocoagulation In Patients With Diabetic Macular Edema Secondary To Diabetic Retinopathy</p>

Abstract

ObjectiveTo evaluate the difference in intravitreal bevacizumab (IVB) injection timing as adjuvant therapy to panretinal photocoagulation in patients with diabetic retinopathy combined with diabetic macular edema.MethodsThis was a retrospective nonrandomized study. Forty eyes with severe non-proliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) were divided into two groups; the IVB injection prior to, or after, panretinal photocoagulation. Changes in central macular thickness between the two groups were measured.ResultsThere was no significant difference in change in central macular thickness between two groups after treatment (p=0.66), neither in eyes with severe NPDR groups (p=0.48) nor eyes with PDR (p=0.82).ConclusionIVB injection after panretinal photocoagulation gives insignificant difference in changes in central macular thickness with injection prior to laser treatment in patients with diabetic retinopathy combined with diabetic macular edema.

Panretinal photocoagulation after or prior to intravitreal conbercept injection for diabetic macular edema: a retrospective study

“…Of note, in our study, we conducted a long-term follow-up and used number of injections as the primary outcome. The loading dose of anti-VEGF therapy in our study were 3 IVC injections while the study Arief et al [ 11 ] did not clarify this issue. After 1 year, the main number of IVC injections in PRP- after group was 4.9 ± 0.95, and 6.4 ± 2.37 in PRP- prior group (5.68 if combined both group), similar to previously report, which range from 4.5 to 6.74 [ 16 , 28 – 30 ].…”

“…When DME is present, both anti-VEGF injections and PRP might be required to treat both DME and PDR. In clinic, however, there is no consensus on which one should be administrated prior to the other [ 9 – 11 ]. Anti-VEGF prior to PPR might favors the relief of macular edema, prompt recovery of visual acuity, and avoidance of DME severity induced by PRP.…”

“…Recently, Arief et al [ 11 ] evaluated the difference in intravitreal bevacizumab (IVB) injection timing as adjuvant therapy to PRP in patients with DME secondary to severe NPDR and PDR, but detected no significant difference in changes in CSMT and BCVA between injection prior to and after PRP. In total, patients in our study gained an increase of logMAR BCVA from 0.83 ± 0.29 to 0.58 ± 0.25 (approximately 2 lines in Snellen chart, p < 0.001) after 2 years.…”

“…In clinical practice, however, there is no consensus on when PRP should be administrated if anti-VEGF treatment is combined [ 9 – 11 ]. On one hand, PRP decreases metabolic demand in the peripheral retina and alleviates the ischemia that drives neovascularization [ 12 ], it is unknown whether or not standard PRP could reduce the number of anti-VEGF injection in the long run.…”