Role of Adjunctive Use of Intravitreal Bevacizumab for Severe Proliferative Diabetic Retinopathy before Vitrectomy

Purpose: To evaluate the safety and efficacy of intravitreal injection of bevacizumab advanced to vitrectomy for severe proliferative diabetic retinopathy. Methods: This is a prospective study in which, Ten eyes of ten patients with an average age 54.1±6.5 years (45-64 years old) complaining of severe proliferative diabetic retinopathy were investigated. An intravitreal injection of 1.25mg bevacizumab was performed 3-10 days prior to planned vitrectomy. A written informed consent was obtained from all patients. All of them were completely evaluated in the out patient department. Fluorescein angiography was advised to every patient. Results: All cases showed minimum bleeding during surgical dissection of fibro-vascular membrane and less post-operative complications were observed. Two eyes receiving bevacizumab 3-10 days before the surgery showed strong fibrosis and adhesion of fibro-vascular membrane, resulted in some surgical complications. The cases having intravitreal bevacizumab for shorter time before vitrectomy did not show extensive fibrosis. Conclusion: Intravitreal bevacizumab was safe and effective in pre treatment of proliferative diabetic retinopathy prior to vitrectomy. It can induce effective regression of retinal neovascularization and rapid clearance of vitreous hemorrhage.