June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
One Year Clinical Outcomes Of A Randomized Clinical Trial Investigating Pre-operative Adjunctive Bevacizumab For Tractional Retinal Detachment (TRD) Due To Proliferative Diabetic Retinopathy (PDR)
Author Affiliations & Notes
  • Elizabeth Tegins
    Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA
  • Michael Javaheri
    Doheny Eye Institute, University of Southern California and Los Angeles County Hospitals, Los Angeles, CA
  • Dean Eliott
    Doheny Eye Institute, University of Southern California and Los Angeles County Hospitals, Los Angeles, CA
    Massachusetts Eye and Ear Infirmary, Boston, MA
  • Leo Kim
    Doheny Eye Institute, University of Southern California and Los Angeles County Hospitals, Los Angeles, CA
    Massachusetts Eye and Ear Infirmary, Boston, MA
  • Hani Salehi-Had
    Doheny Eye Institute, University of Southern California and Los Angeles County Hospitals, Los Angeles, CA
    Atlantis Retina Institute, Huntington Beach, CA
  • David Hinton
    Doheny Eye Institute, University of Southern California and Los Angeles County Hospitals, Los Angeles, CA
    Departments of Pathology and Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA
  • Elliott Sohn
    Department of Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA
    Doheny Eye Institute, University of Southern California and Los Angeles County Hospitals, Los Angeles, CA
  • Footnotes
    Commercial Relationships Elizabeth Tegins, None; Michael Javaheri, None; Dean Eliott, Genentech (C), Regeneron (C), Ophthotech (C), Alcon (C), Bausch & Lomb (C), Allergan (C), Alimera (C), Acucela (C), Arctic (C), Salutaris (C); Leo Kim, None; Hani Salehi-Had, None; David Hinton, RPT (I), RPT (P); Elliott Sohn, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5785. doi:https://doi.org/
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Elizabeth Tegins, Michael Javaheri, Dean Eliott, Leo Kim, Hani Salehi-Had, David Hinton, Elliott Sohn; One Year Clinical Outcomes Of A Randomized Clinical Trial Investigating Pre-operative Adjunctive Bevacizumab For Tractional Retinal Detachment (TRD) Due To Proliferative Diabetic Retinopathy (PDR). Invest. Ophthalmol. Vis. Sci. 2013;54(15):5785. doi: https://doi.org/.

      Download citation file:


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

      ×
  • Supplements
Abstract

Purpose: Utility of pre-operative bevacizumab for TRD due to PDR remains contested due to the risk of TRD progression versus benefit of attenuation of neovascularization. Preliminary three month post-operative data of this reverse translational, double-masked study has been published. In this study, we detail one-year clinical follow-up of this now completed study.

Methods: 20 eyes of 19 patients were randomized to receive intravitreal bevacizumab injection or sham injection 3-7 days prior to vitrectomy for TRD repair and definitive PDR treatment in a large urban, public hospital. Best-corrected visual acuity (BCVA), need for additional procedures, and postoperative complications were compared in the two groups at 6 and 12 month post-operative follow-up.

Results: Median BCVA in the control group was 20/400 at baseline, 20/400 at post-op month 3 (POM3), 20/170 at POM6, and 20/250 at POM12. The median BCVA in the treated group was 20/630 at baseline, 20/100 at POM3, 20/400 at POM6, and 20/150 at POM12. Four of seven eyes (57%) randomized to bevacizumab had the same or improved VA at POM12 compared to five of eight eyes (62.5%) in the control group. All retinas were attached at POM12, but 6 eyes had decreased VA compared to baseline. In the treatment arm, 1 patient had persistent cystoid macular edema, 1 had ischemic changes postoperatively, and 1 had a visually significant cataract awaiting surgery. In the control arm, 1 patient had recurrent epiretinal membrane and 2 developed NLP vision despite retinal attachment: one from glaucoma and another from severe ischemia. During 12 month follow-up, 1 eye in each group needed repeat surgery for recurrent retinal detachment. No eye required enucleation.

Conclusions: Most eyes in this study experienced at least stable VA at one year follow-up. Need for additional surgical procedures for recurrent detachment is uncommon. However, a relatively high risk of poor visual outcomes despite pre-operative bevacizumab still exist in severe TRD due to end-stage PDR.

Keywords: 762 vitreoretinal surgery • 655 proliferative vitreoretinopathy • 499 diabetic retinopathy  
×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×