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Bevacizumab as an adjunct to vitreoretinal surgery for diabetic retinopathy in East Africa

Lookup NU author(s): David Steel

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Abstract

Purpose The purpose of this study is to evaluate the efficacy of preoperative intravitreal bevacizumab (IVB) for improving outcomes in vitrectomy for diabetic retinopathy-related non-clearing vitreous haemorrhage and/or tractional retinal detachment.Methods Medical record from patients undergoing vitrectomy for proliferative diabetic retinopathy (PDR) were retrospectively analysed (2003-2011). From 2007, IVB (1.25 mg 2-4 days before operating) was used on all eyes. Eyes receiving IVB were compared with those that did not receive IVB. Intraoperative complications, reoperation rates, and final visual acuity were the core outcome measures.Results Data were analysed for 88 patients (101 eyes). In all, 41 (41%) patients had received IVB, whereas 60 (59%) patients had not. Significant intraoperative haemorrhage occurred in six eyes (10%) in the non-IVB group and in one (2.4%) IVB eyes (P = 0.24). Silicon oil was used in 29 (48%) non-IVB eyes and in 11 (27%) IVB eyes (P = 0.03). The non-IVB eyes underwent significantly more vitreoretinal reoperations (P = 0.01) and were significantly more likely to lose two or more lines of vision at the final follow-up (P = 0.03). The numbers needed to treat (NNT) blindness (<3/60) was four for non-IVB eyes and two for the IVB group.Conclusions IVB reduces surgical complications, the use of silicon oil, and the need for further retinal surgery. The NNT to restore useful vision (>= 3/60) to a blind eye were significantly lower in the IVB group. Vitreoretinal surgery for the complications of PDR is effective in an East African context, and IVB should be considered a valuable adjunct.


Publication metadata

Author(s): Guthrie G, Hall AB, Dhalla K, Davis RM, Steel DH

Publication type: Article

Publication status: Published

Journal: Eye

Year: 2013

Volume: 27

Issue: 11

Pages: 1263-1268

Print publication date: 01/11/2013

Online publication date: 16/08/2013

Acceptance date: 23/07/2013

ISSN (print): 0950-222X

ISSN (electronic): 1476-5454

Publisher: Nature Publishing Group

URL: http://dx.doi.org/10.1038/eye.2013.182

DOI: 10.1038/eye.2013.182


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