Título

BEVACIZUMAB IN TREATMENT OF PROLIFERATIVE DIABETIC RETINOPATHY (BEPRO STUDY): ANTI-VEGF AS AN ADJUVANT TREATMENT WITH PANRRETINAL PHOTOCOAGULATION IN PROLIFERATIVE DIABETIC RETINOPATHY

Objetivo

To evaluate the efficacy and safety of the use of intravitreous bevacizumab (IVB) combined with panretinal photocoagulation (PRP) in proliferative diabetic retinopathy (PDR).

Método

Open label, non-randomized, prospective, non-controlled interventional study. Inclusion criteria: patients with PDR. Main exclusion criteria: vitreous hemorrhage enough to preclude PRP, tractional retinal detachment greater than 2 disks diameters and history of thromboembolic event in the past 6 months. Eligible patients were submitted to a complete ophthalmic evaluation. Vision acuity (VA) was measured using the ETDRS chart. Fluorescein angiography (FA) and optical coherence tomography (OCT) were also performed at baseline and during follow-up visits. Patients received 2.5mg of IVB 7 to 15 days prior to PRP.

Resultado

36 eyes of 29 patients were enrolled. Seventeen were female. Mean age was 49,9 years (range, 18 to 72 yrs). Mean follow-up was 228,75 days (range, 45-450 days). Mean VA at baseline was 0.508± 0.24 (range, 0 - 1) logMAR units and at the last follow-up visit was 0.506 ± 0.29 (0.1 - 1) logMAR units (p>0.05). Mean OCT macular thickness at baseline was 289,27µ +/-86.6µ and at the last follow-up visit was 314,8 µ +/- 46.2µ (p>0,5). Fifteen days after IVB, FA leakage reduction was complete or partial in all patients. Two eyes of 2 needed a second IVB due to recurrence of neovascularization 180 days after the first IVB in both, an a third injection in one pacient at 225 days. No patients developed significant vitreous hemorrhage or traction retinal detachment, nor worsened or developed macular edema significantly. No ocular or systemic adverse effects were recorded throughout the study.

Conclusão

VA and OCT macular thickness remained stable in patients submitted to IVB followed by PRP. No significant vitreous hemorrhage were oberved. This combined approach is effective and safe in the management of PDR.