To evaluate the effects of intravitreal bevacizumab (IVB) on retinal neovascularization in patients with proliferative diabetic retinopathy (PDR).
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.
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.
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: firstname.lastname@example.org
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.