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G. Garcia-Aguirre, E. Reyna-Castelán, M. Torres-Soriano, V. Kon-Jara, H. Quiroz-Mercado; Intravitreal Bevacizumab vs. Panretinal Photocoagulation for the Treatment of Proliferative and Severe Non-Proliferative Diabetic Retinopathy: A Contralateral Eye Study. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2750.
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To evaluate the results (visual, electroretinographic, angiographic, complication rate) of bi-monthly intravitreal injection of 2.5 mg of bevacizumab in one eye and of panretinal photocoagulation (PRP) in the contralateral eye of patients with symmetric proliferative (PDR) or severe non-proliferative (SNPDR) diabetic retinopathy, at one-year follow-up.
Patients with symmetric PDR or SNPDR without previous treatment were included. In a randomized fashion, one eye underwent PRP (2-3 sessions) and the contralateral eye was treated with 2.5 mg of intravitreal bevacizumab (6 injections in a period of one year). Best corrected visual acuity (BCVA), and OCT were performed at 1, 2, 6 and 12 months. Electroretinogram (ERG) and fluorescein angiogram were performed at baseline, 2 and 6 months.
Ten patients were included, six of them female, average age 53.3 years. Five had PDR and 5 had SNPDR. At the end of follow-up there was no difference in BCVA. Macular thickness increased significantly in patients treated with PRP vs bevacizumab. Mesopic ERG b-wave decreased significantly in eyes treated with PRP vs bevacizumab. Three eyes treated with PRP developed cystic macular edema, one a vitreous hemorrhage and one a subhyaloid hemorrhage. No complications were observed in eyes treated with bevacizumab.
Intravitreal bevacizumab was as effective as PRP for the control of PDR and SNPDR at twelve months follow-up, without the adverse effects (increase in macular thickness and decrease in mesopic ERG b-wave) observed with PRP.
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