Intravitreal Avastin as an adjunct in patients with proliferative diabetic retinopathy undergoing pars plana vitrectomy

Objective: Intravitreal Bevacizumab (Avastin, Genentech Inc., San Francisco, CA) (IVB) has been shown to cause regression of neovessels in proliferative diabetic retinopathy due to its anti-angiogenic effects. This study was performed to investigate the role of Avastin as an adjunct to the management of patients with proliferative diabetic retinopathy undergoing pars plana vitrectomy.

Methodology: Fifty four eyes of 54 patients with proliferative diabetic retinopathy scheduled for surgery were included in the study. They were randomized to vitrectomy with preoperative IVB (group one) or standard vitrectomy (group 2). Group one underwent a single intravitreal injection of bevacizumab 1.25 mg /0.05ml one week prior to vitrectomy. Main outcome measures were best corrected visual acuity (BCVA) after surgery, post-operative complications.

Results: Mean age of the patients was 52.07±5.54 years (range 39-67). At 6 months, 20 patients in group one had BCVA better than baseline as compared to 12 patients in group 2. In group one, only one patient had early post-operative vitreous hemorrhage, whereas 11 patients in group two had early vitreous hemorrhage.

Conclusion: Preoperative IVB is helpful in improving BCVA post operatively, reducing the time of surgery, decreasing the incidence of intraoperative and postoperative bleeding and reducing the frequency of rubeosis and hyphaema.