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INTRAVITREAL BEVACIZUMAB FOR PROLIFERATIVE DIABETIC RETINOPATHY: Results From the Pan-American Collaborative Retina Study Group (PACORES) at 24 Months of Follow-up

Arevalo, J. Fernando MD, FACS; Lasave, Andres F. MD; Wu, Lihteh MD; Maia, Mauricio MD; Diaz-Llopis, Manuel MD; Alezzandrini, Arturo A. MD; Brito, Miguel MDfor the Pan-American Collaborative Retina Study Group (PACORES)

doi: 10.1097/IAE.0000000000001181
Original Study

Purpose: To evaluate the effects of intravitreal bevacizumab (IVB) on retinal neovascularization in patients with proliferative diabetic retinopathy (PDR).

Methods: Retrospective multicenter interventional case series. A chart review was performed of 81 consecutive patients (97 eyes) with retinal neovascularization due to PDR, who received at least 1 IVB injection.

Results: The mean age of the patients was 55.6 ± 11.6 years. The mean number of IVB injections was 4 ± 2.5 injections (range, 1–8 injections) per eye. The mean interval between IVB applications was 3 ± 7 months. The mean duration of follow-up was 29.6 ± 2 months (range, 24–30 months). Best-corrected visual acuity and optical coherence tomography improved statistically significantly (P < 0.0001, both comparisons). Three eyes without previous panretinal photocoagulation (“naive” eyes) and with vitreous hemorrhage did not require vitreoretinal surgery. Five (5.2%) eyes with PDR progressed to tractional retinal detachment requiring vitrectomy. No systemic adverse events were noted.

Conclusion: Intravitreal bevacizumab resulted in marked regression of retinal neovascularization in patients with PDR and previous panretinal photocoagulation. Intravitreal bevacizumab in naive eyes resulted in control or regression of 42.1% of eyes without adjunctive laser or vitrectomy during 24 months of follow-up. There were no safety concerns during the 2 years of follow-up of IVB for PDR.

Long-term intravitreal bevacizumab may result in marked regression of retinal neovascularization in patients with proliferative diabetic retinopathy and previous panretinal photocoagulation. On treatment-naive eyes, primary intravitreal bevacizumab injections resulted in either control or regression of 42.1% of proliferative diabetic retinopathy eyes over 24 months of follow-up. There were no serious complications.

*Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD;

Retina and Vitreous Service, Clínica Privada de Ojos, Mar del Plata, Argentina;

Instituto de Cirugia Ocular, San Jose, Costa Rica;

§Departamento de Oftalmologia, Instituto da Visão, Universidade Federal de São Paulo, São Paulo, Brazil;

Consorcio Hospital, General Universitario de Valencia, Valencia, Spain;

**Facultad de Medicina, OFTALMOS, Universidad de Buenos Aires, Buenos Aires, Argentina; and

††Instituto Docente de Especialidades Oftalmológicas (IDEO), Maracaibo, Venezuela.

Reprint requests: J. F. Arevalo, MD, FACS, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Maumenee 708, Baltimore, MD 21287; e-mail: arevalojf@jhmi.edu

Supported in part by the Edmund F. and Virginia B. Ball Professorship, the Arevalo-Coutinho Foundation for Research in Ophthalmology; and the John and Diana Lenahan Fund, Baltimore, MD (Dr. Arevalo).

None of the authors have any financial/conflicting interests to disclose.

For a complete listing of participating members of PACORES see Appendix 1.

© 2017 by Ophthalmic Communications Society, Inc.