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ALEJANDRA Nieto Nieto Jordan, Alejandro Zermeno, Alejandro Ordonez Campos; Recurrence of vitreous haemorrhage secondary to diabetic retinopathy in patients treated with intraoperative intravitreous Bevacizumab. Invest. Ophthalmol. Vis. Sci. 2018;59(9):204. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Evaluate the recurrence of vitreous haemorrhage (VH) secondary to proliferative diabetic retinopathy (PDR) in patients treated with intraoperative (IO) intravitreous Bevacizumab (IVB)
Study descriptive, retrospective performed in the retina service at the Conde de Valenciana Eye Institute, Mexico City. We included 85 eyes of 82 patients diagnosed with Diabetes Mellitus (DM) 1 and 2, VH secondary to PDR with a follow-up of 6 months after treatment, patients were excluded due to loss of follow-up. We included; 51 women and 34 men, 47 right eyes and 38 left eyes. The surgeries were performed by four expert retina and vitreous surgeons. The patients were divided in 4 groups (G): G1; 28 eyes treated with phacoemulsification (PE) and vitrectomy (VTM) G2; 22 eyes treated with VTM, PE and IO IVB, G3; 20 eyes treated with VTM (pseudophakic) and the G4; 15 eyes underwent VTM and IO IVB. Initial and final visual acuity (VA), evolution of DM, preoperative glucose, recurrent VH and the presence of diabetic macular edema (DME) Laser was applied during surgery to all patients and were assessed at 24 hours, 1,2 weeks and 1,2,3 and 6 months after surgery.
85 eyes with VH secondary to PDR, we included 34 men and 51 women, with an average age of 55.4 years ± 5 years, resulting in 47 right eyes and 38 left eyes.The average time of evolution of DM was 15.3 years ± 4.2 years. The initial VA in all patients was in the range of hand to finger movement. The average glycemia before surgery was 260mg/dl ± 75mg /dl. The G1 had recurrence of VH in 6 eyes (21%) with an average time of 3.1 months, the G2 had recurrence of VH in one eye (4%) at 4.6 months, the G3 had recurrence of VH in 5 eyes (25%) in an average of 2.3 months, and the G4 had no recurrence of VH at 6 months of follow-up. When comparing the patients who received IO IVB against those who did not receive by Fisher's exact test, a P = 0.0102 was obtained, with an OR 0.0934 (95% CI 0.011-0.761, P = 0.0268). When comparing patients who were treated with PE and VTM against patients treated only with VTM, OR 0.9 was observed (95% CI 0.283-3.371 P = 0.9703). The final VA of G1 was 20/80, G2 20/40, G3 20/160 and G4 20/50. The presence of DME was found in 18 eyes (21%).
The use of IO IVB to VH secondary to PDR decreased the risk of presenting recurrence of VH after 6 months of the intervention.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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