Purpose: To describe the experience of authors using intravitreal bevacizumab (IVB) for eyes with recurrent vitreous hemorrhage (VH) after vitrectomy for proliferative diabetic retinopathy.
Methods: Chart review was performed on eligible eyes from the Illinois Retina Associates' patient database that had at least 6 months of follow-up after receiving IVB in the operative eye for recurrent VH after vitrectomy for proliferative diabetic retinopathy.
Results: Twelve eyes of nine patients were included in the study and none required repeat vitrectomy for recurrent VH. Mean follow-up was 22 months (range, 8–42). A mean of 8.1 IVB (range, 1–18) were given. The mean number of recurrent VH was 4 (range, 2–8), and a mean of 3.5 of these VHs (range, 1–8) were clear at the appointment after an injection, typically in 4 to 6 weeks. Patients with history of multiple recurrent VH received prophylactic IVB, and repeated injections at regular intervals were associated with increased time period without recurrent VH.
Conclusion: Intravitreal bevacizumab was a safe and effective adjunct in this series for the management of recurrent VH after vitrectomy for proliferative diabetic retinopathy. No patients required repeat vitrectomy for recurrent VH, and prophylactic IVB was associated with longer periods of clear vitreous in the late postoperative period.
Intravitreal bevacizumab is a safe and effective adjunct for the treatment of recurrent vitreous hemorrhage after diabetic vitrectomy. The need for treatment declined over time, and patients who received prophylactic injections when their vitreous was clear had a significantly increased time period without recurrent vitreous hemorrhage.
*Department of Ophthalmology, Rush University Medical Center, Chicago, Illinois; and
†Illinois Retina Associates, SC, Chicago, Illinois.
Reprint requests: Mathew W. MacCumber, MD, PhD, Department of Ophthalmology, Rush University Medical Center, Rush Professional Office Building, 1725 W. Harrison Street, Suite 906, Chicago, IL 60612; e-mail: MacRetina@gmail.com
Mathew W. MacCumber, MD, PhD: Consultant/Honoraria: Genentech, Regeneron, Allergan, Thrombogenics, ArcticDx, Sequenom, Optos; Grants: Regeneron, Allergan, ArcticDx, Sequenom