title: Panretinal photocoagulation combined with intravitreal bevacizumab in high-risk proliferative diabetic retinopathy.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of intravitreal bevacizumab as an adjunctive treatment to panretinal photocoagulation (PRP) for high-risk proliferative diabetic retinopathy with or without clinically significant macular edema (CSME).
  
  
  METHODS
  In forty-one eyes with high-risk proliferative diabetic retinopathy, intravitreal bevacizumab (1.25 mg/0.05 mL) before PRP (Plus group) or PRP alone (PRP group) was performed. Primary outcome measures were changes in best-corrected visual acuity and central macular thickness (CMT). Secondary outcome measures were the proportion of visual loss >/=0.1 logMAR, increase in CMT >/=50 mum, and eyes with development of vitreous hemorrhage.
  
  
  RESULTS
  Best-corrected visual acuity was significantly worse at 3 months (P = 0.041) in the PRP group, whereas in the plus group, there was no significant change. Central macular thickness decreased significantly at 1 month and 3 months (P = 0.012, 0.008) in the Plus group, whereas in the PRP group, there was no significant change. In eyes with CSME, there was no significant change in best-corrected visual acuity in both groups. Central macular thickness decreased significantly at 1 month and 3 months (P = 0.003, 0.001) in the Plus group, whereas in the PRP group, there was no significant change. In eyes without CSME, best-corrected visual acuity was significantly worse at 1 month and 3 months (P = 0.047, 0.011) in the PRP group, whereas in the Plus group, there was no significant change. Central macular thickness was significantly worse at 1 month and 3 months (P = 0.004, 0.016) in the PRP group, whereas in the Plus group, there was no significant change. In eyes without CSME, the proportion of eyes with visual loss >/=0.1 logMAR at 1 month was significantly higher in the PRP group than in the Plus group (P = 0.020). The proportion of eyes with development of vitreous hemorrhage was significantly lower in the Plus group than in the PRP group (P = 0.023).
  
  
  CONCLUSIONS
  Intravitreal bevacizumab before PRP can be an effective adjunctive treatment to PRP in the treatment of high-risk proliferative diabetic retinopathy, especially if there is not CSME.
authors.affiliation: Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
authors.forename: Won Bin
authors.initials: WB
authors.lastname: Cho
authors.forename: Se Beum
authors.initials: SB
authors.lastname: Oh
authors.forename: Jun Woong
authors.initials: JW
authors.lastname: Moon
authors.forename: Hyung Chan
authors.initials: HC
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D003930:Diabetic Retinopathy / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation; D008266:Macula Lutea / Q000473:pathology; D008269:Macular Edema / Q000150:complications / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011300:Preoperative Care; D012307:Risk Factors; D016896:Treatment Outcome; D014792:Visual Acuity; D014823:Vitreous Hemorrhage / Q000209:etiology; D055815:Young Adult
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab