Abstract
Purpose :
Complications of Proliferative diabetic retinopathy (PDR) is leading cause of severe visual loss in the working age group worldwide. Vitreous haemorrhage has traditionally been managed by observation or pars plana vitrectomy (PPV) since the Diabetic Retinopathy Vitrectomy Studies in the late 80's. In the current study, we investigated the effect of intravitreal avastin (IVAV) injection on the visual outcome following diabetic vitreous haemorrhage.
Methods :
Retrospective study from a single tertiary referral center (KKESH, Riyadh, KSA).One hundred forty five eyes of 145 patients with diabetic vitreous haemorrhage were divided into 4 groups as follows: Observation group (group 1, n=40), PPV group (group 2, n=41), preoperative single IVAV injection followed by PPV (group 3, n=22), and IVAV injections group (group 4, n=42). The primary outcome was corrected distance visual acuity (CDVA) at last follow-up ( months) after the presentation of vitreous haemorrhage. The median duration of follow up was 10.8 months. Analysis of variance was used to assess if there were significant differences across groups with respect to CDVA.
Results :
The baseline CDVA was similar across all groups (p=0.5). There was a trend for better CDVA in the IVAV injection group at last follow-up (p=0.05), with the proportion of eyes having CDVA 20/20 to 20/60 as follows: Group 1 (22.5%), group 2 (34.1%), group 3 (45.5%), group 4 (59.5%). The proportion of patients with poor metabolic control (blood sugar level higher than 7 mmol/dl) was significantly higher in group 4 (p=0.005). Age, gender, prevalance of hypertension and nephropathy did not differ significantly between groups.
Conclusions :
There was a trend towards better visual outcome with intravitreal avastin injection compared to observation or PPV for management of diabetic vitreous haemorrhage.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.