Prospective Evaluation of Intravitreal Bevacizumab on Outcomes of Proliferative Vitreoretinopathy (PVR)-related Retinal Detachment Surgery

Abstract

Purpose: To investigate the effect of intravitreal bevacizumab (1.25mg/0.05mL) on retinal re-attachment rate and visual acuity outcomes in patients undergoing proliferative vitreoretinopathy (PVR)-related retinal detachment (RD) repair.

Methods: Prospective, non-randomized pilot study of 20 patients undergoing pars plana vitrectomy (PPV) and silicone oil tamponade with or without scleral buckling procedure (SBP) for recurrent RD due to PVR. Intravitreal injection of 1.25mg bevacizumab was performed at time of RD surgery and then monthly for the subsequent 3-month period. Retinal re-attachment rate and visual acuity outcomes were compared to matched historical controls at 3 months.

Results: Twenty patients (mean age 59.5 years; 7 female, 13 male) were included in the study group. All patients underwent PPV with silicone oil tamponade for PVR-related RD. Eight of 20 eyes had concurrent (n=4) or prior (n=4) SBP. Perfluorocarbon liquid was utilized in all cases. Mean logMAR visual acuity improved from 1.78 ± 0.42 (Snellen equivalent 20/1200) preoperatively to 1.39 ± 0.66 (Snellen equivalent 20/500, p= 0.01) at month 3. Following enrollment, single (study) surgery anatomic success rate was achieved in 11/20 eyes (55%). Final anatomic reattachment was achieved during the 3-month follow-up period in 15/20 eyes (75%) after a mean of 1.35 operations. Compared to a historical control group composed of 40 patients undergoing repair for PVR-related retinal detachment (mean age 63.5 years; 16 female, 24 males), no statistically significant difference in single (study) surgery anatomic success rate (p=0.41), final anatomic success rate (p=0.15), and final visual acuity (p=0.49) was observed at 3 months. No intravitreal bevacizumab or injection-related adverse events were encountered in the study group.

Conclusions: In this prospective pilot study, intravitreal bevacizumab injections used at the time of surgery and at post-operative months 1, 2, and 3 did not improve short-term anatomic or visual acuity outcomes in patients undergoing PVR-related retinal detachment surgery when compared to historical controls.