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G. Z. Ramos, V. C. C. Afonso, A. U. Vargas, L. T. Dalfré, R. B. Dichtchekenian, A. F. Bordon; Intravitreal Bevacizumab in Treatment of Proliferative Diabetic Retinopathy: BePRO Study. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2745.
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To evaluate the efficacy and safety of the use of intravitreous bevacizumab (IVB) combined with panretinal photocoagulation (PRP) in proliferative diabetic retinopathy (PDR).
Open label, non-randomized, prospective, non-controlled interventional study. Inclusion criteria were patients with PDR. Main exclusion criteria were presence of vitreous hemorrhage enough to preclude PRP, tractional retinal detachment greater than 2 disks diameters and history of thromboembolic event in the past 6 months. Eligible patients were submitted to a complete ophthalmic evaluation. Vision acuity (VA) was measured using the ETDRS chart. Fluorescein angiography (FA) and optical coherence tomography (OCT) were also performed at baseline and during follow-up visits. Patients received 2.5mg of IVB 7 to 15 days prior to PRP.
Eight eyes of six patients were enrolled. Two were male. Five were right eyes. Mean age was 41.5 years (23 to 59). Mean follow-up was 198.75 days (90-300). Mean VA at baseline was 0.31 (0-0.7) and at the last follow-up visit was 0.21 (0-0.7). Fifteen days after IVB, FA leakage reduction was complete or partial in all 8 eyes. Mean OCT foveal thickness was 256µ +/-82.6µ; 235.6 µ +/-35.5 µ and 247.85 µ +/-50.8 µ at baseline, 90 days and at 180 days, respectively. One eye needed a second IVB due to recurrence of neovascularization 180 days after the first IVB. No patients developed vitreous hemorrhage or traction retinal detachment, nor worsened or developed macular edema. No ocular or systemic adverse effects were recorded throughout the study.
VA and OCT macular thickness remained stable in patients submitted to IVB followed by PRP. This combined approach is effective and safe in the management of PDR.
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