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The
Impact of Bevacizumab in Combination with Pan-Retinal
Photocoagulation in High Risk Proliferative Diabetic Retinopathy
Cases, Comparative Study
Mamdouh M. Kabeel,
Ashraf A. Al Batarney, Mustafa A. Abu-Elenin & Mohammed M. Tameesh
Ophthalmology Department, Faculty of Medicine, Tanta University,
Egypt.
Article type: Original article
Aim: To evaluate the effects of Pan retinal photocoagulation (PRP)
alone as a treatment of high risk Proliferative diabetic retinopathy
(PDR) compared to the intravitreal Avastin injection in combination
with PRP for the same cases. Patients & Methods: 60 patients were
enrolled in this prospective randomized study as all patients were
diagnosed as high risk PDR. The right eyes of all patients were
treated by PRP full scatter and the left eyes were treated by 1.25
mg. Avastin injection in 0.1 ml two days prior also to full scatter
PRP treatment in two sessions two weeks apart. Pre-treatment as well
as post-treatment full ophthalmological assessment was done for all
eyes in the two groups in the form of best corrected visual
acuity(BCVA), Fluorescein Angiography, and also central foveal
thickness by optical coherence tomography(OCT), all eyes were
followed-up for one year. Results: There was a significant
difference between the PRP and the PRP assisted group in the area of
fluorescein leakage from active neovascularization elsewhere (NVE).
As regards BCVA, there was a significant difference between the two
groups at the end of follow-up period, favoring the PRP assisted
group by at least two lines (P=0.05). Also, the total area of
actively leaking NVE’s was significantly lower in PRP assisted group
compared to the PRP group only (P<0.001). The rate of complication
in the form of vitreous hemorrhage and epiretinal membrane formation
was also higher in the PRP group only but it was not statistically
significant. Conclusion: The combined used of intravitreal Avastin
with PRP for the high risk cases of PDR seems to give a more
stabilized effect on the degree of PDR as well as on vision compared
to the PRP treatment alone.
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