Anterior Retinal Cryotherapy and Intravitreal Injection of Bevacizumab in the Treatment of Nonclearing Vitreous Hemorrhage in Proliferative Diabetic Retinopathy

作者：Hsieh Min Chin; Yeh Po Ting; Yang Chung May^*; Yang Chang Hao

来源：Journal of Ocular Pharmacology and Therapeutics, 2014, 30(4): 353-358.

DOI：10.1089/jop.2013.0104

Purpose: 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 1.25mg 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 6.98.7 weeks and 13.0 +/- 9.3 weeks respectively (P=0.003). Conclusion: Combined treatment of ARC and IVB is associated with more rapid clearing of VH in eyes with PDR compared with IVB alone.

• 出版日期2014-5-1