title: Efficacy of intravitreal bevacizumab combined with pan retinal photocoagulation versus panretinal photocoagulation alone in treatment of proliferative diabetic retinopathy.
abstract: OBJECTIVE
  To compare effectiveness of pan-retinal photocoagulation alone versus panretinal photocoagulation combined with intravitreal bevacizumab on visual acuity and central macular thickness in patients presenting with proliferative diabetic retinopathy.
  
  
  METHODS
  This Randomized controlled trial was carried out at Armed Forces Institute of ophthalmology, Pakistan from Jan 2016 to Aug 2016. Seventy six eyes of 50 patients having proliferative diabetic retinopathy and diabetic macular edema were included in the study. All the patients were subjected to detailed clinical examination that included Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), slit lamp examination of anterior and posterior segments. Optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) were carried out and patients were divided in two groups (GP and GI). Three monthly sessions of Pan retinal photocoagulation (PRP) using Pattern Scan Laser (PASCAL) alone was performed in group GP while PRP along with three monthly intravitreal bevacizumab (IVB) was performed in group GI. BCVA and CMT was recorded 04 weeks after the third PRP session in both the groups.
  
  
  RESULTS
  Seventy six eyes of 50 patients (38 in each group) were treated with three sessions of PRP alone and PRP with IVB in Group GP and GI respectively. Mean age of the patient in group GP was 57.47± 6.08 years while that in group GI was 55.69 ±6.58. The magnitude of induced change in BCVA was 0.09 ± 0.15 in GP while 0.22 + 0.04 in GI groups while mean induced change in CMT after treatment was 77.44 ± 92.30 um and 117.50 ± 93.82 um in group GP and GI.
  
  
  CONCLUSIONS
  Laser PRP combined with IVB has superior visual and anatomical outcome than PRP alone in patients with combined presentation of PDR and DME.
authors.affiliation: Dr. Murtaza Sameen, MBBS. Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan.
authors.forename: Murtaza
authors.initials: M
authors.lastname: Sameen
authors.affiliation: Dr. Muhammad Saim Khan, MBBS, FCPS, FICO, MRCSEd. Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan.
authors.forename: Muhammad Saim
authors.initials: MS
authors.lastname: Khan
authors.affiliation: Dr. Ahsan Mukhtar, FCPS (Ophth), FCPS (Vitreoretina), FRCS (G). Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan.
authors.forename: Ahsan
authors.initials: A
authors.lastname: Mukhtar
authors.affiliation: Dr. Muhammad Amer Yaqub, MCPS, FCPS, FRCSEd. Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan.
authors.forename: Muhammad Amer
authors.initials: MA
authors.lastname: Yaqub
authors.affiliation: Prof. Dr. Mazhar Ishaq, FCPS, FRCOphth, FRCSEd. Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan.
authors.forename: Mazhar
authors.initials: M
authors.lastname: Ishaq
keywords: Diabetic macular edema; Intravitreal Bevacizumab; Laser pan-retinal photocoagulation; Proliferative diabetic retinopathy