Abstract
Purpose:
To investigate the effects of panretinal photocoagulation(PRP) combined with an intravitreal bevacizumab as an adjuvant to diabetic retinopathy(DMR).
Methods:
We carried out a prospective study of patients with DMR and no prior treatment who were randomly assigned to receive PRP (PRP group) or intravitreal bevacizumab plus PRP (bevacizumab PRP group). Patients with diabetic macular edema were excluded. A single intravitreal bevacizumab injection was administered one week before the laser treatment starts. All patients had at least six months follow-up. Best corrected visual acuity (BCVA), vitreous hemorrhage, vitrectomy, new vessels(NV) at retina, neovascular glaucoma, tractional retinal detachment and complications of intravitreal injection were analyzed.
Results:
One hundred ninety-one eyes of 125 patients with severe NPDR, very severe NPDR(122 eyes, 80 patients: PRP group 95 eyes, 54 patients: bevacizumab PRP group 27eyes, 26 patients) and early PDR(69 eyes, 45 patients: PRP group 47 eyes, 32 patients: bevacizumab PRP group 22 eyes, 13 patients) were included in this study. Only `probability of vitrectomy` in the bevacizumab PRP group with severe NPDR, very severe NPDR patients showed a increase than PRP only group(p=0.003). There were no statistically significant differences in BCVA, probability of vitreous hemorrhage, vitrectomy, new vessels(NV) at retina, neovascular glaucoma, tractional retinal detachment between the 2 groups in early PDR patients. There was no adverse effect of intravitreal injections.
Conclusions:
Intravitreal bevacizumab injection with PRP for severe to very severe NPDR increase probability of vitrectomy than PRP alone.
Keywords: 499 diabetic retinopathy •
688 retina •
561 injection