Abstract
Purpose: :
To report the use of intravitreal bevacizumab in patients affected by florid proliferative diabetic retinopathy (FPDR).
Methods: :
We evaluated retrospectively three consecutive cases treated with 1,25 mg bevacizumab.
Results: :
Case 1. 28 years old female was referred to our clinic because of FPDR with vitreous hemorrhage in OS and neovascular glaucoma in previously vitrectomized OD. We performed one intravitreal injection in the right eye and two in the left one. We noticed the regression of iris neovessels in OD and a progressive clearing of the vitreous hemorrhage in OS that allowed the completing of a Panretinal photocoagulation (PRP).Case 2. 30 years old female was referred to our clinic in 2005 because of FPDR with vitreous hemorrhage in OD. Treated with vitrectomy and panretinal endophotocoagulation, she developed phthisis of the right eye. Six months later she presented a FPDR in the OS and was treated with two intravitreal bevacizumab injections respectively before and one month after the PRP.Case 3. 25 years old man was referred to our clinic because of FPDR with vitreous hemorrhage, moderate in OD and severe OS. He received two intravitreal injection in OO. In OD we were able to perform a complete PRP while in OS the persisting of vitreous hemorrhage required vitreous surgery and panretinal endophotocoagulation.In all the three cases one year follow up showed in the injected eyes a complete regression of the retinal neovascularization.
Conclusions: :
FPDR is characterized by a bilateral rapidly progressive severe ischemic retinopathy. The treatment of FPDR consist in an extensive PRP and early vitrectomy when necessary. Intravitreal bevacizumab injection may be considered an useful adjunct to the standard care.
Keywords: diabetic retinopathy • vascular endothelial growth factor • vitreoretinal surgery