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Department of Retina and Vitreous Instituto de Oftalmologia Conde de Valenciana, M.D. Objective: To document proliferative control of fluorescein angiography in diabetic retinopathy after intravitreal bevacizumab and hemiretinal photocoagulation, compared to a complete panretinal photocoagulation in the contralateral eye.
Material and Methods: Patients with bilateral and symmetrical proliferative diabetic retinopathy without history of previous treatment were included. The right eye received intravitreal bevacizumab and a single session of 800 scattered laser spots. The left eye underwent a full 1,600 laser panretinal photocoagulation. Angiography was performed monthly for 6 months to document inactivity of the diabetic retinopathy. Statistical significance in between eyes of persistent angiographic activity, time of reapplication and also number of retreatments with panretinal photocoagulation were analyzed using T-tests set as p<0.05.
Results: 109 patients were enrolled. In the first month, 16.6% of right eyes presented activity, compared to 34% of left eyes (p<0.05); the difference was statistically significant up to the 4th month. In the 5th and 6th months, the activity in both eyes was not statistically significant. The median time of reapplying laser in the right eyes was 112 days, compared to 65 days in the left. In the first four months, the left eye was retreated 3 times more than the right eye.
Conclusions: Applying bevacizumab with half panretinal photocoagulation is more effective in inactivating the proliferative diabetic retinopathy, compared to a full panretinal photocoagulation up to the 4th month. Adding bevacizumab accelerates the time of inactivity in the angiography, avoids up to twice the time for reapplying laser and is 3 times less likely to be retreated. Keywords : Avastin, PRP, diabetic retinopathy