September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Investigation of intravitreal bevacizumab injections in the treatment of vitreous hemorrhage due to proliferative diabetic retinopathy
Author Affiliations & Notes
  • Rupin Parikh
    Ophthalmology, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
    Albany Medical College, Albany, New York, United States
  • Anastasia Traband
    Ophthalmology, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Thomas A Quinn
    Touro College of Osteopathic Medicine, New York, New York, United States
  • Alexander J Brucker
    Ophthalmology, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Rupin Parikh, None; Anastasia Traband, None; Thomas Quinn, None; Alexander Brucker, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 6323. doi:
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      Rupin Parikh, Anastasia Traband, Thomas A Quinn, Alexander J Brucker; Investigation of intravitreal bevacizumab injections in the treatment of vitreous hemorrhage due to proliferative diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6323.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The definitive treatment for proliferative diabetic retinopathy (PDR) has been panretinal photocoagulation (PRP). PDR can present with vitreous hemorrhage (VH) which can hinder the ability to perform PRP. In these situations two options include observation or pars plana vitrectomy (PPV). Another option may be treatment with an intravitreal anti-VEGF injection in an attempt to cause regression of neovascularization and prevent further bleeding. This study investigates the outcome of patients treated with intravitreal bevacizumab (IVB) for PDR in the setting of VH to determine the need for additional treatment during a minimum follow up of one year.

Methods : We performed a retrospective chart review of patients who presented to the Scheie Eye Institute between January 2008 and January 2015 with VH in the setting of PDR and were treated with IVB. After inclusion criteria were applied, such as a minimal follow up of one year, 129 eyes were eligible. Outcomes include the number of injections given, time to PRP, and whether PPV was performed.

Results : Of the 129 eyes eligible, 93 (72.1%) did not require vitrectomy. 50 of the 93 eyes were treated with PRP with 25 of the 50 requiring more than one injection. 43 of the 93 eyes received no laser, with 19 requiring only one injection and 24 requiring multiple injections. 36 of 129 eligible eyes (27.9%) underwent PPV within one year of follow up. 23 of the 36 eyes were performed for non-clearing VH (n = 21) or recurrent VH (n = 2). 13 of the 36 eyes underwent PPV for tractional retinal detachment (TRD), all of which were present prior to anti-VEGF treatment.

Conclusions : Based on our results, IVB injections may be a reasonable first line treatment to offer patients with PDR who present with VH. Our study indicates that approximately 72% of patients treated with IVB for PDR in the setting of VH can be managed without PPV. These results warrant additional investigation, such as a randomized controlled trial comparing rates of PPV among patients who do and do not receive anti-VEGF injections for VH and PDR and that monthly injections may not be necessary.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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