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P. Tsai, K. K. Kamat, N. J. Pathak, K. Z. Danek, R. M. Ahuja; Intravitreal Bevacizumab (Avastin) in Patients With Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1419. doi: https://doi.org/.
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To determine the efficacy of intravitreal bevacizumab in patients with proliferative diabetic retinopathy with vitreous hemorrhage and/or iris neovascularization (NVI) not amenable to panretinal photocoagulation.
A retrospective analysis of 14 eyes of 12 patients given intravitreal injections of bevacizumab for proliferative diabetic retinopathy was performed at the Stroger Hospital of Cook County, Division of Ophthalmology. All patients enrolled received informed consent and a complete ophthalmic examination. Patients received 1.25 mg of bevacizumab in a 0.05 ml intravitreal dose. Post-injection examinations were performed between 1 to 3 days and then at 1 to 2 months.
Of the 12 patients half were female, and the average age was 52 years (28-69 years). Eleven eyes (79%) showed improvement of vitreous hemorrhage and/or NVI. Vitreous hemorrhage improved in 7 out of 13 eyes, and NVI improved in 5 out of 5 eyes. Of the eyes with NVI, 4 out of 5 eyes showed complete resolution, the earliest occurring 3 days post injection (mean 14 days). Patients were followed for a mean of 39.8 days (range 1-95 days). No adverse events were seen.
In this short follow-up period, intravitreal bevacizumab (Avastin) injection appears to be safe and well tolerated in patients with proliferative diabetic retinopathy. Rubeosis iridis responded particularly well to treatment with rapid resolution. Though vitreous hemorrhage did not fully resolve, clearance was observed in over half the patients, which subsequently permitted panretinal photocoagulation. Additional study is necessary to determine the long-term safety and efficacy of intravitreal bevacizumab in patients with proliferative diabetic retinopathy.
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