title: Intravitreal bevacizumab for proliferative diabetic retinopathy with new dense vitreous hemorrhage after full panretinal photocoagulation.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of intravitreal bevacizumab (IVB) injections for the treatment of proliferative diabetic retinopathy (PDR) with new dense vitreous hemorrhage (VH) after previous full panretinal photocoagulation (PRP).
  
  
  METHODS
  Prospective study of consecutive PDR with prior complete PRP patients, who presented with new dense VH, were treated with IVB injection. Complete ophthalmic examination and/or ocular ultrasonography were performed at baseline and 1, 6, and 12 weeks and 6, 9, and 12 months after the first injection. Reinjection was done in non-clearing and recurrent VH.
  
  
  RESULTS
  Eighteen eyes of 18 patients, mean age 47.7 ± 12.69 years were included. In all, 14 (77.78%) patients had type 2 diabetes mellitus. Systemic hypertension and dyslipidemia were the most common systemic diseases. All cases were phakic eye with previous complete PRP. Patients received 1.6 ± 0.42 intravitreal injections over a 12-month period. VH cleared completely in 7 (38.89%), 9 (50%), and 13 (72.22%) eyes after 6 weeks, 6 months, and 12 months, respectively. Re-bleeding, however, occurred in 10 (56%) eyes during the follow-up period, and 5 (28%) eyes still had residual VH at the last visit. Statistically significant visual gain was observed in 9 (50%) eyes. Unfortunately, 2 (11%) eyes had severe visual loss because of the tractional retinal detachment (TRD). Mild ocular complication was detected in one patient.
  
  
  CONCLUSIONS
  IVB injection had good efficacy and safety for treatment of new VH in patients with PDR and prior complete PRP. This procedure may be especially relevant for diabetic patients at high-risk for surgical intervention.
authors.affiliation: Department of Ophthalmology, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Sinawat
authors.affiliation: Department of Ophthalmology, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: T
authors.initials: T
authors.lastname: Rattanapakorn
authors.affiliation: Department of Ophthalmology, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: T
authors.initials: T
authors.lastname: Sanguansak
authors.affiliation: Department of Ophthalmology, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Y
authors.initials: Y
authors.lastname: Yospaiboon
authors.affiliation: Department of Physiology, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: S
authors.initials: S
authors.lastname: Sinawat
mesh_terms: D000328:Adult; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D050171:Dyslipidemias / Q000150:complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D058449:Intravitreal Injections; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D015861:Retinal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D014823:Vitreous Hemorrhage / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D055815:Young Adult
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab
references.citation: J Ophthalmol. 2012;2012:852183
references.pmid: 22132316
references.citation: Ophthalmology. 2009 Oct;116(10):1943-8
references.pmid: 19699531
references.citation: Br J Ophthalmol. 2010 Jul;94(7):858-63
references.pmid: 20606024
references.citation: Br J Ophthalmol. 2011 Sep;95(9):1337-9
references.pmid: 21527416
references.citation: Ophthalmology. 2006 Oct;113(10):1695.e1-15
references.pmid: 17011951
references.citation: Retina. 2009 Apr;29(4):516-22
references.pmid: 19262436
references.citation: Ophthalmology. 1992 Sep;99(9):1351-7
references.pmid: 1407968
references.citation: Cochrane Database Syst Rev. 2012 Dec 12;12:CD007419
references.pmid: 23235642
references.citation: Acta Ophthalmol. 2008 Jun;86(4):385-9
references.pmid: 17995982
references.citation: Clin Ophthalmol. 2007 Jun;1(2):149-55
references.pmid: 19668504
references.citation: Graefes Arch Clin Exp Ophthalmol. 2010 May;248(5):641-50
references.pmid: 20012643
references.citation: Ophthalmology. 2009 May;116(5):927-38
references.pmid: 19269033
references.citation: Br J Ophthalmol. 2012 May;96(5):614-8
references.pmid: 22133988
references.citation: Br J Ophthalmol. 2008 Feb;92(2):213-6
references.pmid: 17965108
references.citation: Curr Diabetes Rev. 2011 May;7(3):176-84
references.pmid: 21438852
references.citation: BMJ. 2012 Aug 13;345:e5182
references.pmid: 22890029
references.citation: JAMA Ophthalmol. 2013 Mar;131(3):283-93
references.pmid: 23370902
references.citation: Clinicoecon Outcomes Res. 2012;4:361-74
references.pmid: 23248574
references.citation: Eye (Lond). 2009 Jan;23(1):117-23
references.pmid: 17891058
references.citation: Retina. 2006 Nov-Dec;26(9):1006-13
references.pmid: 17151487
references.citation: Br J Ophthalmol. 2009 Nov;93(11):1474-8
references.pmid: 19692371
references.citation: Curr Eye Res. 2012 Aug;37(8):661-70
references.pmid: 22631452
references.citation: Acta Ophthalmol. 2011 Nov;89(7):e567-72
references.pmid: 21726427
references.citation: Acta Ophthalmol. 2011 Aug;89(5):405-11
references.pmid: 21294854
references.citation: Am J Ophthalmol. 2013 Jul;156(1):106-115.e2
references.pmid: 23791371
references.citation: Graefes Arch Clin Exp Ophthalmol. 2008 Dec;246(12):1699-705
references.pmid: 18696095
references.citation: Ophthalmic Epidemiol. 2007 Jul-Aug;14(4):179-83
references.pmid: 17896294
references.citation: Korean J Ophthalmol. 2009 Dec;23(4):266-72
references.pmid: 20046686
references.citation: Cochrane Database Syst Rev. 2011 May 11;(5):CD008214
references.pmid: 21563165
references.citation: Graefes Arch Clin Exp Ophthalmol. 2010 Jul;248(7):915-30
references.pmid: 20174816
references.citation: Eye (Lond). 2009 May;23(5):1238-9
references.pmid: 18551139
references.citation: Retina. 2009 Sep;29(8):1134-40
references.pmid: 19672218
references.citation: Ophthalmology. 1981 Jul;88(7):583-600
references.pmid: 7196564
references.citation: Acta Ophthalmol. 2009 Sep;87(6):683-4
references.pmid: 19021597
references.citation: Retina. 2010 Nov-Dec;30(10):1646-50
references.pmid: 20634777
references.citation: Eye (Lond). 2010 Aug;24(8):1315-9
references.pmid: 20224599
references.citation: Eur J Ophthalmol. 2008 Mar-Apr;18(2):263-9
references.pmid: 18320520