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Intravitreal Bevacizumab (Avastin) in the Surgical Treatment of Proliferative Diabetic Retinopathy
Diabetic Retinopathy Highlights from Retina/Vitreous Free Papers
| Sunday, November 12, 2006 |
| Robert L Avery, MD, Joel A Perlman, MD, Dante Pieramici, MD, Melvin D Rabena, MD, Alexandro A Castellarin, MD, Ma’an A Nasir, MD, Matthew J Giust, MD, Robert T Wendel, MD, Arun Patel, MD
Dr Avery has previously published the results on 45 eyes treated with bevacizumab in Ophthalmology (provide citation). This study reports a second series of 45 eyes with complications of proliferative diabetic retinopathy (PDR) treated with bevacizumab prior to vitrectomy. Indications for vitrectomy included vitreous hemorrhage, trational retinal detachment, or neovascular glaucoma. Neovascularization was evaluated by angiography. 40 eyes received 1 injection, 4 eyes received 2 injections, and 1 eye received 3 injections. Postinjection angiography revealed dramatic reduction or complete resolution of neovascularization. Spontaneously clearing vitreous hemorrhage occurred in 27% of patients. During the vitrectomy, bleeding when removing fibrovascular tissue was dramatically reduced and documented on video. Serious ocular adverse events included 1 postoperative retinal detachment; a second patient had 1 tractional retinal detachment later. Intravitreal bevacizumab induces marked regression of neovascularization and may be a valuable adjunct to vitrectomy for complications of PDR, warranting further study.
Dr Haller complimented Dr Avery on a thoughtful study. Dr Avery mentioned that not having to contend with bleeding during surgery is really nice. One of the panelists inquired about the effect of bevacizumab on endothelial cells. Dr Avery stated that while he has no proof, the thought a benefit “is lurking there.�
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