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Kevin Ferenchak, Renaud Duval, Jack Cohen, Mathew MacCumber; Intravitreal Bevacizumab for Post-Operative Vitreous Hemorrhage After Vitrectomy for Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):208.
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© ARVO (1962-2015); The Authors (2016-present)
To describe our experience using intravitreal bevacizumab for eyes with recurrent vitreous hemorrhage after vitrectomy for proliferative diabetic retinopathy.
The patient database of Illinois Retina Associates was searched for patients who had received vitrectomy for diabetic retinopathy and at least one bevacizumab injection to the operative eye for post-operative vitreous hemorrhage (VH). Patients who had less than 6 months follow-up after vitrectomy were excluded. Snellen visual acuity measurements were converted to logMAR visual acuity for analysis and then converted back to report results.
There were 12 eyes of 9 patients that were included in the study. Follow-up after primary vitrectomy had mean of 24.5 months (median 18.5 months, range of 8 to 52.5 months). Two eyes with severe vitreous hemorrhages had a second vitrectomy and one of these also had an outpatient fluid-air exchange early in the post-operative period. A mean of 8.75 bevacizumab injections (median 7, range 1 to 19 injections) were given in the post-operative period for recurrent VH. During the post-operative period the mean number of recurrent VHs was 4 (median 3, range 2-8). Of the 12 eyes, 10 had total resolution of the VH by the last post-operative visit. The visual acuity before the first bevacizumab injection had mean of counting fingers (median counting fingers, range 20/100 to hand motions). Final visual acuity had mean of 20/80 (median 20/60 and range 20/20 to CF).
Intravitreal bevacizumab is a useful adjunct for the management of recurrent VH in eyes that had undergone vitrectomy for PDR. Patients often required multiple injections and had recurrent VH when the treatment was stopped, however the need for treatment declined over time. Repeat vitrectomy or fluid-air exchange was not required for most eyes and, when employed, was only used in the early post-operative period for the most severe cases.
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