July 2019
Volume 60, Issue 9
Free
ARVO Annual Meeting Abstract  |   July 2019
The efficacy of intravitreal bevacizumab in treating recurrent vitreous hemorrhage after pars plana vitrectomy for diabetic vitreous hemorrhage
Author Affiliations & Notes
  • Maram Abdalla-Elsayed
    Saudi Ministry of Health, Kingston Upon Thames, ENGLAND, United Kingdom
  • Ibrahim Taskintuna
    King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia
  • Patrik Schatz
    King Khalid Eye Specialist Hospital, Riyadh, Saudi Arabia
    Lund University, Sweden
  • Igor Kozak
    Moorfields, United Arab Emirates
  • Footnotes
    Commercial Relationships   Maram Abdalla-Elsayed, None; Ibrahim Taskintuna, None; Patrik Schatz, None; Igor Kozak, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6542. doi:https://doi.org/
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      Maram Abdalla-Elsayed, Ibrahim Taskintuna, Patrik Schatz, Igor Kozak; The efficacy of intravitreal bevacizumab in treating recurrent vitreous hemorrhage after pars plana vitrectomy for diabetic vitreous hemorrhage. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6542. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the efficacy of intravitreal bevacizumab in treating recurrent vitreous hemorrhage (VH) after pars plana vitrectomy (PPV) for diabetic vitreous hemorrhage

Methods : Consecutive patients with recurrent VH occurring between 2 weeks and 2 years after primary diabetic vitrectomy were treated with intravitreal injections of bevacizumab. No subsequent vitreous surgery was performed during follow up, and all patients were followed for at least 1 year after the clearance of VH. Visual acuity (VA) was measured at baseline (2 weeks after PPV), during VH and at the most recent follow up. Primary outcome was the percentage of baseline VA restored at last follow up. Factors affecting primary outcome were analysed. Additionally, Kaplan-Meier analysis was used to investigate demographic and clinical factors (hypertension, dyslipidemia and diabetic nephropathy) affecting vitreous clear-up time after VH (VCT).

Results : The study included 10 eyes of 10 patients, mean (SD) age=61.30 (11.01) years, and mean±SD total follow up time=823.0±266.6 days. Postoperative VH occurred between 11 - 602 days (median=84 days) resulting in 92.49% of mean vision loss as mean±SD VA dropped from 0.50±0.17 to 0.03±0.02. Re-bleeding occurred in 2 out of 10 cases. Management required 1-4 injections of bevacizumab (mean=2.1 injections), enabling restoration of 20-100% of baseline VA (mean=74.6%, median=91.25%). No significant association was found between the percentage of baseline VA restored and demographic and clinical factors. VCT was obtained after 3 to 18.6 weeks (mean±SD VCT=10.1±4.84 weeks). Paradoxically, there was a positive relationship between VCT and percentage of vision restoration (linear regression: B=0.66, r=0.684, p=0.029). Kaplan-Meier analysis showed no significant association of VCT with demographic or clinical factors.

Conclusions : Intravitreal bevacizumab treatment may serve as an alternative to revitrectomy for recurrent VH after diabetic vitrectomy as it enabled satisfactory visual outcomes. There was no significant association of VCT with demographic or clinical factors.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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