The Efficacy of Antivascular Endothelial Growth Factor (Bivacizumab) Pretreatment before Vitrectomy for Patients with Complicated Proliferative Diabetic Retinopathy

Abstract

Background/aims: To evaluate the efficacy of antivascular endothelial growth factor (anti-VEGF) agents pretreatment before vitrectomy for patients with complicated proliferative diabetic retinopathy (PDR)

Methods: A retrospective research was done on (29)  Proliferative Diabetic Retinopathy (PDR) eyes who were divided into two groups, group A (n=19) Pars Plana Vitrectomy (PPV) with preoperative Intra Vitreous Bevacizumab (IVB ) and PPV group B (n=10). Bevacizumab was injected 4-8 days before PPV. Main outcome measures were visual acuity, incidence of iatrogenic retinal breaks, intraoperative bleeding ,surgery time and final tamponed.

Results: At six month after surgery, visual acuity in group A: IVB PPV (84.2%) and  group  B: PPV (80%) improved significantly and the difference between the two groups was not significant. Iatrogenic retinal breaks were reported in 3 cases (15.7%) in group A and 4 cases (40%) in IVB group. Intraoperative bleeding was encountered in all cases in two groups but it was less annoying in group A. median surgery time was in group A 91 minute, and in group B 120 minute. In group A13 eye ( 68.4%) was tamponed with Silicon oil while 6 eyes(31.5%) tamponed with air, and in group B all 10 eyes (100%) was tamponed with silicon oil.

Conclusion: The pretreatment of anti-VEGF agents before vitrectomy for patients with complicated PDR facilitates much faster surgery and better visual rehabilitation, reduces iatrogenic retinal breaks, and silicon oil tamponad. Moreover, studies with larger sample sizes are required to further evaluation the efficacy of anti-VEGF agents and reach a firmer conclusion.