Short-term Effect of Intravitreal Bevacizumab Injection Preventing Panretinal Photocoagulation-Induced Macular Edema in Proliferative Diabetic Retinopathy

Sub Kim Jung; Ra Ho

doi:10.3341/jkos.2009.50.8.1197

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Jung and Ho: Short-term Effect of Intravitreal Bevacizumab Injection Preventing Panretinal Photocoagulation-Induced Macular Edema in Proliferative Diabetic Retinopathy

Original Article

J Korean Ophthalmol Soc 2009;50(8):1197-1203.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.8.1197

Short-term Effect of Intravitreal Bevacizumab Injection Preventing Panretinal Photocoagulation-Induced Macular Edema in Proliferative Diabetic Retinopathy

Sub Kim Jung, MD, Ra Ho, MD

Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Ho Ra, MD Department of Ophthalmology, Holy Family Hospital, College of Medicine, The Catholic University of Korea #2 Sosa-dong, Wonmi-gu, Bucheon 420-717, Korea Tel: 82-32-340-2125, Fax: 82-32-340-2255, E-mail: raho@catholic.ac.kr

Received 4 February 200919 May 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

To investigate the effect of intravitreal bevacizumab injection in preventing panretinal photocoagulation (PRP)-induced macular edema and visual dysfunction in proliferative diabetic retinopathy.

Methods:

We conducted a prospective study of 40 consecutive eyes (20 patients) with proliferative diabetic retinopathy whose visual acuity (logMAR) was 0.2 or less, foveal thickness (µ m) was 280 or less, and retinopathy was bilaterally symmetrical. In Group 1 (20 eyes), PRP was performed with intravitreal bevacizumab injection 1 week before the initiation of PRP, but in Group 2 (20 eyes) PRP alone was performed. In all eyes, PRP was completed using the same technique. Best corrected visual acuity (BCVA) and foveal and parafoveal thicknesses were measured before treatment and 1 and 3 months after PRP.

Results:

Before treatment, the mean BCVA and foveal and parafoveal thicknesses were not statistically significantly different between the two groups (p >0.05). At 1 and 3 months after PRP, the mean BCVA improved and the foveal and parafoveal thicknesses were significantly smaller in Group 1 than in Group 2 (p <0.05).

Conclusions:

Intravitreal bevacizumab injection before PRP could help prevent PRP-induced macular edema and visual dysfunction in patients with proliferative diabetic retinopathy and good vision.

Keywords: Bevacizumab, Macular edema, Panretinal photocoagulation, Proliferative diabetic retinopathy

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Figure 1.

Bar graph illustrating percentage of eyes of each group according to best corrected visual acuity (BCVA) 3 months after treatment

Table 1.

Demographic data of intravitreal bevacizumab injected group (Group 1) and control group (Group 2)

Variables	Group 1 (n=20)	Group 2 (n=20)	p^‡
Gender
Male	12	14
Female	8	6
Age (years)	53.5±6.79	54.1±6.15	0.871
Duration of DM^† (years)	9.15±4.53	8.98±5.01	0.678
Hemoglobin A1C (%)	7.16±0.87	7.24±0.69	0.632
Hypertension	125.7±12.3	128.1±10.3	0.545
(systolic/diastolic)	/83.1±14.1	/87.4±11.7	/0.501
Lens
Phakic	16	18
Pseudophakic	4	2

^∗ BCVA=best corrected visual acuity

^† DM=diabetes mellitus

^‡ P=Student ttest.

Table 2.

Comparison of BCVA^∗, foveal and parafoveal thickness for intravitreal bevacizumab injected group (Group 1) and control group (Group 2)

Variables	Group 1 (n=20)	Group 2 (n=20)	p^‡
BCVA (logMAR^†)
Baseline	0.117±0.070	0.113±0.055	0.844
1 month	0.107±0.072	0.216±0.144	0.005
3 month	0.099±0.075	0.222±0.171	0.007
Foveal thickness (µm)
Baseline	240.5±25.9	238.4±24.4	0.798
1 month	227.1±25.4	291.2±75.1	0.001
3 month	222.9±26.2	292.8±77.2	0.001
Parafoveal thickness(µm)
Baseline	302.8±34.7	310.3±22.3	0.419
1 month	300.2±28.6	350.5±52.9	0.001
3 month	295.6±25.3	352.9±48.9	0.001

^∗ BCVA=best corrected visual acuity

^† logMAR=logarithm of the minimum angle of resolution

^‡ p=Student ttest.

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