title: Anterior retinal cryotherapy and intravitreal injection of bevacizumab in the treatment of nonclearing vitreous hemorrhage in proliferative diabetic retinopathy.
abstract: OBJECTIVE
  To evaluate the efficacy of intravitreal bevacizumab (IVB) injection combined with anterior retinal cryotherapy (ARC) in the treatment of proliferate diabetic retinopathy (PDR) with vitreous hemorrhage (VH).
  
  
  METHODS
  A retrospective case controlled study was performed on 67 cases (67 patients) with PDR and persistent VH obscuring the fundus detail for ≧3 weeks. The follow-up period was ≧6 months. Cases with extensive vitreo-retinal adhesion by ultrasonography were excluded. In the study group, transconjunctival ARC (a total of 12 spots) followed by IVB 1.25 mg was performed in the same setting; in the control group, only IVB was given. Panretinal photocoagulation was performed when possible. Repeated IVB was performed in both groups if VH persisted for >4 weeks following the initial treatment. Vitrectomy was performed if VH showed no improvement for 12 to 16 weeks. The vitreous clear-up time (VCUT) in the posterior pole and the rate of vitrectomy were compared between the 2 groups.
  
  
  RESULTS
  In the study group (n=35), second treatment was required in 7 out of 35 patients (20.0%). Vitrectomy was performed in 5 (14.3%) patients. In the control group (n=32), 8 out of 32 eyes (25.0%) underwent second injection. Four eyes (12.5%) had vitrectomy within the follow-up time. VCUT in the study and the control group was 6.9±8.7 weeks and 13.0±9.3 weeks respectively (P=0.003).
  
  
  CONCLUSIONS
  Combined treatment of ARC and IVB is associated with more rapid clearing of VH in eyes with PDR compared with IVB alone.
authors.affiliation: 1 Department of Ophthalmology, National Taiwan University Hospital , Taipei, Taiwan .
authors.forename: Min-Chin
authors.initials: MC
authors.lastname: Hsieh
authors.forename: Po-Ting
authors.initials: PT
authors.lastname: Yeh
authors.forename: Chung-May
authors.initials: CM
authors.lastname: Yang
authors.forename: Chang-Hao
authors.initials: CH
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D016022:Case-Control Studies; D017679:Cryotherapy / Q000379:methods; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000601:surgery; D005260:Female; D006801:Humans; D058449:Intravitreal Injections / Q000379:methods; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000187:drug effects* / Q000601:surgery; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014821:Vitrectomy / Q000379:methods; D014823:Vitreous Hemorrhage / Q000188:drug therapy* / Q000601:surgery; D055815:Young Adult
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab