Abstract
Purpose :
To evaluate the effectiveness of postoperative bevacizumab in preventing neovascular glaucoma (NVG) and to identify associated risk factors in patients with proliferative diabetic retinopathy (PDR) undergoing phacovitrectomy.
Methods :
86 patients diagnosed with PDR who underwent phacovitrectomy between January 1, 2015, and January 1, 2023, were retrospectively enrolled in the study. Patients were categorized into two subgroups based on their postoperative treatment regimen: one group received bevacizumab within two months following the phacovitrectomy, while the other did not receive bevacizumab during this period. Subsequently, a comparative analysis was conducted to evaluate the distinguishing characteristics between these two groups. Kaplan-Meier survival analysis was employed to determine the incidence rate of NVG following phacovitrectomy. Furthermore, a multivariate analysis using the Cox proportional hazards model was conducted to identify risk factors associated with the development of NVG post-phacovitrectomy.
Results :
A total of 86 eyes from 86 patients were included in the study. NVG developed in 20 eyes (23.25%). The probability of NVG occurrence at 6 and 12 months after phacovitrectomy was 12.79% and 18.60%, respectively. The average time to NVG manifestation was 6.3 ± 4.52 months. The mean follow-up period was 49.69 ± 22.29 months. When comparing the group that received bevacizumab within 2 months after phacovitrectomy (n=38) to the group that did not receive bevacizumab (n=48), there was no statistically significant difference in other factors. However, there was a significant difference in the occurrence of NVG (p<0.001). In the group that received bevacizumab within 2 months after surgery, there were only two cases of NVG (5.26%), while all the other NVG cases occurred in the group that did not receive bevacizumab (37.5%). Elevated levels of HbA1c (p=0.035) were found to be associated with the occurrence of NVG following phacovitrectomy and the administration of bevacizumab within two months post-phacovitrectomy demonstrated efficacy in preventing the development of NVG (p=0.004).
Conclusions :
Postoperative bevacizumab significantly reduced the incidence of NVG in phacovitrectomy patients, with concurrent risk factor analysis providing insights for tailored preventive strategies in proliferative diabetic retinopathy.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.