Purchase this article with an account.
L. Saldarriaga, J. Arevalo, J. G. Sanchez, M. H. Berrocal, J. J. Fromow-Guerra, L. Wu, M. Maia, M. J. Saravia, J. Bareño, for the Pan-American Collaborative Retina Study Group; Risk Factors for the Development or Progression of Tractional Retinal Detachment (TRD) After Intravitreal Bevacizumab (Avastin) Used as an Adjuvant to Vitrectomy for the Management of Severe Proliferative Diabetic Retinopathy (PDR). Invest. Ophthalmol. Vis. Sci. 2010;51(13):4239.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To determine the risk factors for the development or progression of TRD after intravitreal bevacizumab (Avastin) used as an adjuvant to vitrectomy for the management of severe PDR.
Multicenter retrospective interventional study at 6 centers from 6 countries. The clinical charts of patients who experienced the development or progression of TRD after an intravitreal injection of 1.25 or 2.5 mg of bevacizumab before vitrectomy for the management of PDR were reviewed. Twenty-five eyes (patients) out of 698 intravitreal injections that developed or had progression of TRD were identified. Nineteen (73%) eyes had received a dose of 1.25 mg, and 6 (27%) eyes had received a dose of 2.5 mg. Clinical parameters of these patients previously identified as potential risk factors for TRD were obtained and analyzed and compared to the clinical characteristics of those patients that did not developed a TRD after IVB for PDR. Statistical analysis was performed using a bivariate analysis (Stata version 10.1).
Twenty-five eyes (patients) out of 698 intravitreal injections (3.6%) developed or had progression of TRD after intravitreal bevacizumab (1.25 mg: 19 TRD out of 626 injections: 3%; 2.5 mg: 6 TRD out of 72 injections: 8.3%). Risk factors for TRD after IVB identified in our study included, more than 15 years from the diagnosis of diabetes mellitus (DM) (p = 0.009), (OR = 0.30), (95CI = 0.10 - 0.83), (RR= 0.35), more than 13 days from injection to vitrectomy (p = 0.0001), (OR = 9.9), (95CI = 3.4 - 29), (RR = 6.9) and the use of a higher dose (2.5 mg) of bevacizumab (p = 0.022), (OR = 2.7), (95CI= 1.05 - 7.18), (RR = 2.38).
The use of IVB as an adjuvant to vitrectomy for the management of severe PDR may be associated to the development or progression of TDR. Based on this bivariate analysis, risk factors for TRD after IVB in PDR are time from diagnosis of DM of more than 15 years, time interval from IVB to vitrectomy of more than 13 days, and the use of the higher dose of IVB (2.5 mg).
This PDF is available to Subscribers Only