Bevacizumab (Avastin) as an Adjunct to Vitrectomy in the Management of Severe Proliferative Diabetic Retinopathy: A Prospective Case Series

Purpose: To evaluate the role of preoperative intravitreal bevacizumab as an adjunct to vitrectomy in diabetic eye disease. Methods: Twenty eyes of 18 patients were recruited and underwent a single intravitreal injection of bevacizumab 1.25 mg 1 week prior to vitrectomy. Fundus fluorescein angiography (FFA) was done before and 1 week after injections. Best corrected visual acuity (BCVA) and ophthalmic evaluation were done before, 1 week after injections, 1 day, 1 week and monthly for 3 months after vitrectomy. Results: The mean age was 47.7 +/- 10.39 years. The male: female ratio was 2:3. Mean preinjection BCVA (logMAR) was 1.460 +/- 0.439. FFA showed a dramatic reduction in dye leakage 1 week after injection. Intraoperative bleedings were minimal in most cases (85%, n = 17). Postoperatively, 16 patients had no bleeding (80%), 4 had minimal bleeding (20%), and 1 had recurrent fibrovascular proliferation (5%). The mean BCVA on day 1, week 1, months 2 and 3 after surgery were 1.645 +/- 0.422, 1.300 +/- 0.413, 1.065 +/- 0.538 and 1.065 +/- 0.538 log-MAR, respectively (p = 0.078, 0.123, 0.002 and 0.002, respectively). Conclusion: Bevacizumab administered prior to vitrectomy was well tolerated and was particularly useful during surgery. Copyright (C) 2010 S. Karger AG, Basel