Intravitreal Bevacizumab (Avastin) and Panretinal Photocoagulation in the Treatment of High-Risk Proliferative Diabetic Retinopathy
To report the short-term efficacy and safety of intravitreal bevacizumab (Avastin) injection with panretinal laser photocoagulation (PRP) in patients with high-risk proliferative diabetic retinopathy (PDR) according to the Early Treatment Diabetic Retinopathy Study criteria. A prospective, intervent...
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| Veröffentlicht in: | Journal of ocular pharmacology and therapeutics 2013-07, Vol.29 (6), p.550-555 |
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| creator | YANG, Chang-Sue HUNG, Kuo-Che HUANG, Yi-Ming HSU, Wen-Ming |
| description | To report the short-term efficacy and safety of intravitreal bevacizumab (Avastin) injection with panretinal laser photocoagulation (PRP) in patients with high-risk proliferative diabetic retinopathy (PDR) according to the Early Treatment Diabetic Retinopathy Study criteria.
A prospective, interventional case series study was conducted in 17 patients (20 eyes) with high-risk PDR, who were treated with intravitreal bevacizumab (2.5 mg) followed by PRP when the peripheral vitreous became clear or 2 weeks after injection. Patients underwent complete ophthalmic evaluation, including Snellen visual acuity and fluorescein angiography at baseline, 1, 3, and 6 months after bevacizumab injection. Main outcome measures included the serial changes in visual acuity, vitreous clear-up time, and neovascularization on the disc (NVD) regression time.
All patients had obvious reduction in angiographic leakage and involution of retinal neovascularization (NV) at the 1- and 3-month follow-up. The mean follow-up time was 7.5 months. The vitreous hemorrhage (VH) showed a partial resolution as early as 1 week, and complete regression at 3 months. The mean vitreous clear-up time after intravitreal Avastin was 8.5±2.2 weeks. The mean time interval from intravitreal Avastin to NVD regression was 10.8±3.4 weeks. Mean logarithm of the minimum angle resolution visual acuity improved from 1.03 at baseline to 0.36 at 1-month, 0.38 at 3-month, and 0.48 at the 6-month follow-up (P |
| doi_str_mv | 10.1089/jop.2012.0202 |
| format | Article |
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A prospective, interventional case series study was conducted in 17 patients (20 eyes) with high-risk PDR, who were treated with intravitreal bevacizumab (2.5 mg) followed by PRP when the peripheral vitreous became clear or 2 weeks after injection. Patients underwent complete ophthalmic evaluation, including Snellen visual acuity and fluorescein angiography at baseline, 1, 3, and 6 months after bevacizumab injection. Main outcome measures included the serial changes in visual acuity, vitreous clear-up time, and neovascularization on the disc (NVD) regression time.
All patients had obvious reduction in angiographic leakage and involution of retinal neovascularization (NV) at the 1- and 3-month follow-up. The mean follow-up time was 7.5 months. The vitreous hemorrhage (VH) showed a partial resolution as early as 1 week, and complete regression at 3 months. The mean vitreous clear-up time after intravitreal Avastin was 8.5±2.2 weeks. The mean time interval from intravitreal Avastin to NVD regression was 10.8±3.4 weeks. Mean logarithm of the minimum angle resolution visual acuity improved from 1.03 at baseline to 0.36 at 1-month, 0.38 at 3-month, and 0.48 at the 6-month follow-up (P<0.01). Three eyes (18%) required vitrectomy surgery during follow-up. The indication for vitrectomy was dense, persistent VH in 2 eyes, and focal tractional retinal detachment (TRD) in 1 eye. Recurrent retinal NV with minor preretinal hemorrhage was observed in 6 eyes (30%) 3 months after the first injection, and resolved after repeated bevacizumab injections. Patients received an average of 1.4 injections (range: 1-2). Seven eyes (35%) underwent 2 injections. One eye (5%) had ocular complication of PDR progression to TRD. No systemic adverse events were observed following injections.
Short-term results suggest combined intravitreal bevacizumab and PRP achieved rapid clearance of VH, regression of retinal NV, and visual improvement in the treatment of high-risk PDR. Long-term study is warranted to assess the long-term efficacy and safety.</description><identifier>ISSN: 1080-7683</identifier><identifier>EISSN: 1557-7732</identifier><identifier>DOI: 10.1089/jop.2012.0202</identifier><identifier>PMID: 23495932</identifier><language>eng</language><publisher>Larchmont, NY: Liebert</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Angiogenesis Inhibitors - administration & dosage ; Angiogenesis Inhibitors - adverse effects ; Angiogenesis Inhibitors - therapeutic use ; Antibodies, Monoclonal, Humanized - administration & dosage ; Antibodies, Monoclonal, Humanized - adverse effects ; Antibodies, Monoclonal, Humanized - therapeutic use ; Bevacizumab ; Biological and medical sciences ; Combined Modality Therapy ; Diabetes. Impaired glucose tolerance ; Diabetic Retinopathy - complications ; Diabetic Retinopathy - drug therapy ; Diabetic Retinopathy - pathology ; Diabetic Retinopathy - therapy ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Female ; Humans ; Intravitreal Injections ; Light Coagulation - methods ; Male ; Medical sciences ; Middle Aged ; Ophthalmology ; Original ; Pharmacology. Drug treatments ; Prospective Studies ; Retinal Neovascularization - drug therapy ; Retinal Neovascularization - etiology ; Retinal Neovascularization - pathology ; Retinal Neovascularization - therapy ; Retinopathies ; Severity of Illness Index ; Treatment Outcome ; Vitreous Hemorrhage - drug therapy ; Vitreous Hemorrhage - etiology ; Vitreous Hemorrhage - pathology ; Vitreous Hemorrhage - therapy</subject><ispartof>Journal of ocular pharmacology and therapeutics, 2013-07, Vol.29 (6), p.550-555</ispartof><rights>2014 INIST-CNRS</rights><rights>Copyright 2013, Mary Ann Liebert, Inc. 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-66ca18f84fa1826602f48af589e405a8fbadf3c5767493e5270030aff1f799393</citedby><cites>FETCH-LOGICAL-c483t-66ca18f84fa1826602f48af589e405a8fbadf3c5767493e5270030aff1f799393</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27571998$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23495932$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>YANG, Chang-Sue</creatorcontrib><creatorcontrib>HUNG, Kuo-Che</creatorcontrib><creatorcontrib>HUANG, Yi-Ming</creatorcontrib><creatorcontrib>HSU, Wen-Ming</creatorcontrib><title>Intravitreal Bevacizumab (Avastin) and Panretinal Photocoagulation in the Treatment of High-Risk Proliferative Diabetic Retinopathy</title><title>Journal of ocular pharmacology and therapeutics</title><addtitle>J Ocul Pharmacol Ther</addtitle><description>To report the short-term efficacy and safety of intravitreal bevacizumab (Avastin) injection with panretinal laser photocoagulation (PRP) in patients with high-risk proliferative diabetic retinopathy (PDR) according to the Early Treatment Diabetic Retinopathy Study criteria.
A prospective, interventional case series study was conducted in 17 patients (20 eyes) with high-risk PDR, who were treated with intravitreal bevacizumab (2.5 mg) followed by PRP when the peripheral vitreous became clear or 2 weeks after injection. Patients underwent complete ophthalmic evaluation, including Snellen visual acuity and fluorescein angiography at baseline, 1, 3, and 6 months after bevacizumab injection. Main outcome measures included the serial changes in visual acuity, vitreous clear-up time, and neovascularization on the disc (NVD) regression time.
All patients had obvious reduction in angiographic leakage and involution of retinal neovascularization (NV) at the 1- and 3-month follow-up. The mean follow-up time was 7.5 months. The vitreous hemorrhage (VH) showed a partial resolution as early as 1 week, and complete regression at 3 months. The mean vitreous clear-up time after intravitreal Avastin was 8.5±2.2 weeks. The mean time interval from intravitreal Avastin to NVD regression was 10.8±3.4 weeks. Mean logarithm of the minimum angle resolution visual acuity improved from 1.03 at baseline to 0.36 at 1-month, 0.38 at 3-month, and 0.48 at the 6-month follow-up (P<0.01). Three eyes (18%) required vitrectomy surgery during follow-up. The indication for vitrectomy was dense, persistent VH in 2 eyes, and focal tractional retinal detachment (TRD) in 1 eye. Recurrent retinal NV with minor preretinal hemorrhage was observed in 6 eyes (30%) 3 months after the first injection, and resolved after repeated bevacizumab injections. Patients received an average of 1.4 injections (range: 1-2). Seven eyes (35%) underwent 2 injections. One eye (5%) had ocular complication of PDR progression to TRD. No systemic adverse events were observed following injections.
Short-term results suggest combined intravitreal bevacizumab and PRP achieved rapid clearance of VH, regression of retinal NV, and visual improvement in the treatment of high-risk PDR. Long-term study is warranted to assess the long-term efficacy and safety.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angiogenesis Inhibitors - administration & dosage</subject><subject>Angiogenesis Inhibitors - adverse effects</subject><subject>Angiogenesis Inhibitors - therapeutic use</subject><subject>Antibodies, Monoclonal, Humanized - administration & dosage</subject><subject>Antibodies, Monoclonal, Humanized - adverse effects</subject><subject>Antibodies, Monoclonal, Humanized - therapeutic use</subject><subject>Bevacizumab</subject><subject>Biological and medical sciences</subject><subject>Combined Modality Therapy</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic Retinopathy - complications</subject><subject>Diabetic Retinopathy - drug therapy</subject><subject>Diabetic Retinopathy - pathology</subject><subject>Diabetic Retinopathy - therapy</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Female</subject><subject>Humans</subject><subject>Intravitreal Injections</subject><subject>Light Coagulation - methods</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Ophthalmology</subject><subject>Original</subject><subject>Pharmacology. Drug treatments</subject><subject>Prospective Studies</subject><subject>Retinal Neovascularization - drug therapy</subject><subject>Retinal Neovascularization - etiology</subject><subject>Retinal Neovascularization - pathology</subject><subject>Retinal Neovascularization - therapy</subject><subject>Retinopathies</subject><subject>Severity of Illness Index</subject><subject>Treatment Outcome</subject><subject>Vitreous Hemorrhage - drug therapy</subject><subject>Vitreous Hemorrhage - etiology</subject><subject>Vitreous Hemorrhage - pathology</subject><subject>Vitreous Hemorrhage - therapy</subject><issn>1080-7683</issn><issn>1557-7732</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkc9vFCEUx4mxsbV69Gq4mOhhVn7MDHAxaau2TZq4aeqZvGVhhzoLG2AnqVf_cZm0tvb0HuHD54X3RegdJQtKpPp8G3cLRihbEEbYC3REu040QnD2svZEkkb0kh-i1znfEkI56ekrdMh4qzrF2RH6cxlKgsmXZGHEp3YC43_vt7DCH08myMWHTxjCGi8hJFtPFVoOsUQTYbMfofgYsA-4DBbfVEXZ2lBwdPjCb4bm2udfeJni6J1NlZ0s_uphVT0GX8-2uIMy3L1BBw7GbN8-1GP08_u3m7OL5urH-eXZyVVjWslL0_cGqHSydbWwvifMtRJcJ5VtSQfSrWDtuOlEL1rFbccEIZyAc9QJpbjix-jLvXe3X23t2tj566PeJb-FdKcjeP38JvhBb-KkuSCyZ7QKmnuBSTHnZN3jW0r0nIauaeg5DT2nUfn3_w98pP-tvwIfHgDIBkaXIBifnzjRCaqU5H8BfKGWUw</recordid><startdate>20130701</startdate><enddate>20130701</enddate><creator>YANG, Chang-Sue</creator><creator>HUNG, Kuo-Che</creator><creator>HUANG, Yi-Ming</creator><creator>HSU, Wen-Ming</creator><general>Liebert</general><general>Mary Ann Liebert, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20130701</creationdate><title>Intravitreal Bevacizumab (Avastin) and Panretinal Photocoagulation in the Treatment of High-Risk Proliferative Diabetic Retinopathy</title><author>YANG, Chang-Sue ; HUNG, Kuo-Che ; HUANG, Yi-Ming ; HSU, Wen-Ming</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-66ca18f84fa1826602f48af589e405a8fbadf3c5767493e5270030aff1f799393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angiogenesis Inhibitors - administration & dosage</topic><topic>Angiogenesis Inhibitors - adverse effects</topic><topic>Angiogenesis Inhibitors - therapeutic use</topic><topic>Antibodies, Monoclonal, Humanized - administration & dosage</topic><topic>Antibodies, Monoclonal, Humanized - adverse effects</topic><topic>Antibodies, Monoclonal, Humanized - therapeutic use</topic><topic>Bevacizumab</topic><topic>Biological and medical sciences</topic><topic>Combined Modality Therapy</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetic Retinopathy - complications</topic><topic>Diabetic Retinopathy - drug therapy</topic><topic>Diabetic Retinopathy - pathology</topic><topic>Diabetic Retinopathy - therapy</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Female</topic><topic>Humans</topic><topic>Intravitreal Injections</topic><topic>Light Coagulation - methods</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Ophthalmology</topic><topic>Original</topic><topic>Pharmacology. Drug treatments</topic><topic>Prospective Studies</topic><topic>Retinal Neovascularization - drug therapy</topic><topic>Retinal Neovascularization - etiology</topic><topic>Retinal Neovascularization - pathology</topic><topic>Retinal Neovascularization - therapy</topic><topic>Retinopathies</topic><topic>Severity of Illness Index</topic><topic>Treatment Outcome</topic><topic>Vitreous Hemorrhage - drug therapy</topic><topic>Vitreous Hemorrhage - etiology</topic><topic>Vitreous Hemorrhage - pathology</topic><topic>Vitreous Hemorrhage - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>YANG, Chang-Sue</creatorcontrib><creatorcontrib>HUNG, Kuo-Che</creatorcontrib><creatorcontrib>HUANG, Yi-Ming</creatorcontrib><creatorcontrib>HSU, Wen-Ming</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of ocular pharmacology and therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>YANG, Chang-Sue</au><au>HUNG, Kuo-Che</au><au>HUANG, Yi-Ming</au><au>HSU, Wen-Ming</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intravitreal Bevacizumab (Avastin) and Panretinal Photocoagulation in the Treatment of High-Risk Proliferative Diabetic Retinopathy</atitle><jtitle>Journal of ocular pharmacology and therapeutics</jtitle><addtitle>J Ocul Pharmacol Ther</addtitle><date>2013-07-01</date><risdate>2013</risdate><volume>29</volume><issue>6</issue><spage>550</spage><epage>555</epage><pages>550-555</pages><issn>1080-7683</issn><eissn>1557-7732</eissn><abstract>To report the short-term efficacy and safety of intravitreal bevacizumab (Avastin) injection with panretinal laser photocoagulation (PRP) in patients with high-risk proliferative diabetic retinopathy (PDR) according to the Early Treatment Diabetic Retinopathy Study criteria.
A prospective, interventional case series study was conducted in 17 patients (20 eyes) with high-risk PDR, who were treated with intravitreal bevacizumab (2.5 mg) followed by PRP when the peripheral vitreous became clear or 2 weeks after injection. Patients underwent complete ophthalmic evaluation, including Snellen visual acuity and fluorescein angiography at baseline, 1, 3, and 6 months after bevacizumab injection. Main outcome measures included the serial changes in visual acuity, vitreous clear-up time, and neovascularization on the disc (NVD) regression time.
All patients had obvious reduction in angiographic leakage and involution of retinal neovascularization (NV) at the 1- and 3-month follow-up. The mean follow-up time was 7.5 months. The vitreous hemorrhage (VH) showed a partial resolution as early as 1 week, and complete regression at 3 months. The mean vitreous clear-up time after intravitreal Avastin was 8.5±2.2 weeks. The mean time interval from intravitreal Avastin to NVD regression was 10.8±3.4 weeks. Mean logarithm of the minimum angle resolution visual acuity improved from 1.03 at baseline to 0.36 at 1-month, 0.38 at 3-month, and 0.48 at the 6-month follow-up (P<0.01). Three eyes (18%) required vitrectomy surgery during follow-up. The indication for vitrectomy was dense, persistent VH in 2 eyes, and focal tractional retinal detachment (TRD) in 1 eye. Recurrent retinal NV with minor preretinal hemorrhage was observed in 6 eyes (30%) 3 months after the first injection, and resolved after repeated bevacizumab injections. Patients received an average of 1.4 injections (range: 1-2). Seven eyes (35%) underwent 2 injections. One eye (5%) had ocular complication of PDR progression to TRD. No systemic adverse events were observed following injections.
Short-term results suggest combined intravitreal bevacizumab and PRP achieved rapid clearance of VH, regression of retinal NV, and visual improvement in the treatment of high-risk PDR. Long-term study is warranted to assess the long-term efficacy and safety.</abstract><cop>Larchmont, NY</cop><pub>Liebert</pub><pmid>23495932</pmid><doi>10.1089/jop.2012.0202</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1080-7683 |
| ispartof | Journal of ocular pharmacology and therapeutics, 2013-07, Vol.29 (6), p.550-555 |
| issn | 1080-7683 1557-7732 |
| language | eng |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Adult Aged Aged, 80 and over Angiogenesis Inhibitors - administration & dosage Angiogenesis Inhibitors - adverse effects Angiogenesis Inhibitors - therapeutic use Antibodies, Monoclonal, Humanized - administration & dosage Antibodies, Monoclonal, Humanized - adverse effects Antibodies, Monoclonal, Humanized - therapeutic use Bevacizumab Biological and medical sciences Combined Modality Therapy Diabetes. Impaired glucose tolerance Diabetic Retinopathy - complications Diabetic Retinopathy - drug therapy Diabetic Retinopathy - pathology Diabetic Retinopathy - therapy Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Female Humans Intravitreal Injections Light Coagulation - methods Male Medical sciences Middle Aged Ophthalmology Original Pharmacology. Drug treatments Prospective Studies Retinal Neovascularization - drug therapy Retinal Neovascularization - etiology Retinal Neovascularization - pathology Retinal Neovascularization - therapy Retinopathies Severity of Illness Index Treatment Outcome Vitreous Hemorrhage - drug therapy Vitreous Hemorrhage - etiology Vitreous Hemorrhage - pathology Vitreous Hemorrhage - therapy |
| title | Intravitreal Bevacizumab (Avastin) and Panretinal Photocoagulation in the Treatment of High-Risk Proliferative Diabetic Retinopathy |
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