Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 Jun 21;30(3):276-279.
doi: 10.1016/j.joco.2018.06.001. eCollection 2018 Sep.

The Effect of Bevacizumab Before Vitrectomy for Diabetic Tractional Retinal Detachment Demonstrated on Optical Coherence Tomography Angiography

Affiliations
Free PMC article
Case Reports

The Effect of Bevacizumab Before Vitrectomy for Diabetic Tractional Retinal Detachment Demonstrated on Optical Coherence Tomography Angiography

Soon Wai Ch'ng et al. J Curr Ophthalmol. .
Free PMC article

Abstract

Purpose: To demonstrate the effect of intravitreal bevacizumab (IVB) on the size and vascularity of the fibro-vascular complex with the optical coherence tomography angiography (OCTA) before pars plana vitrectomy (PPV).

Methods: Observational case series of three eyes with active diabetic fibro-vascular complex and tractional retinal detachment (TRD) who underwent IVB (1.25 mg/0.05 ml) two days before proceeding to PPV. OCTA was carried out prior to IVB, two days after IVB and six weeks after PPV.

Results: OCTA showed a reduction in the size and calibre of the diabetic fibro-vascular complex two days after IVB in all the cases. Consequently, there was less traumatic dissection of the fibro-vascular membranes during PPV and thus reduced chances of intraoperative and postoperative vitreous cavity bleeding. One case showed mild hemorrhage in the posterior vitreous on the second day post-injection which implies the increased traction caused by IVB.

Conclusions: In this case series, we have used OCTA to demonstrate how IVB is highly effective in reducing the vascularity of diabetic fibro-vascular membranes. This finding also suggests that the use of IVB before PPV in the management of diabetic TRD could also be much shorter than the advocated standard practice of one week in most institutions.

Keywords: Bevacizumab; Diabetic tractional retinal detachment; OCTA; Vitreous hemorrhage.

Figures

Fig. 1
Fig. 1
From the left to the right: Swept-source optical coherence tomography angiography (SS OCTA) (top) and B Scan SS OCT images (bottom) before intravitreal bevacizumab (IVB), two days after IVB and 6 weeks after pars plana vitrectomy (PPV). Red arrow indicates the superior edge of the fibro-vascular membrane before and 2 days after IVB (with the contraction of the membrane).
Fig. 2
Fig. 2
From left to right: Optical coherence tomography angiography (OCTA) of the fibro-vascular complex and B Scan Swept-source optical coherence tomography angiography (SS OCTA) of the fibro-vascular complex. From top to bottom: before intravitreal bevacizumab (IVB), two days from IVB and 6 weeks from pars plana vitrectomy (PPV). Note the reduced size and branching of the vascular complex after IVB (red arrow) and the mild hemorrhage in the posterior vitreous on the second day post-injection (yellow arrow) implying the increased traction caused by IVB.
Fig. 3
Fig. 3
From left to right: fundus image of the area of active proliferative retinal vessel and optical coherence tomography angiography (OCTA) of the fibro-vascular complex. From top to bottom: before intravitreal bevacizumab (IVB) and two days after IVB (with the decrease size of the active proliferative retinal vessel).

Similar articles

See all similar articles

References

    1. Rice T.A., Michels R.G., Rice E.F. Vitrectomy for diabetic traction retinal detachment involving the macula. Am J Ophthalmol. 1983;95(1):22–33. - PubMed
    1. Ho T., Smiddy W.E., Flynn H.W. Vitrectomy in the management of diabetic eye disease. Surv Ophthalmol. 1992;37(3):190–202. - PubMed
    1. Blankenship G.W. Management of vitreous cavity hemorrhage following pars plana vitrectomy for diabetic retinopathy. Ophthalmology. 1986;93(1):39–44. - PubMed
    1. Yorston D., Wickham L., Benson S., Bunce C., Sheard R., Charteris D. Predictive clinical features and outcomes of vitrectomy for proliferative diabetic retinopathy. Br J Ophthalmol. 2008;92(3):365–368. - PubMed
    1. Novak M.A., Rice T.A., Michels R.G., Auer C. Vitreous hemorrhage after vitrectomy for diabetic retinopathy. Ophthalmology. 1984;91(12):1485–1489. - PubMed

Publication types

LinkOut - more resources

Feedback