[Does preoperative intravitreal bevacizumab reduce complications of vitrectomy for proliferative diabetic retinopathy?]

Medwave. 2014 Dec 12;14(11):e6052. doi: 10.5867/medwave.2014.11.6052.
[Article in Spanish]

Abstract

Proliferative diabetic retinopathy carries a high risk of blindness if it is not timely treated. The treatment many times includes vitrectomy. Bevacizumab, an anti-vascular endothelial growth factor, may decrease intraoperative complications. Searching in Epistemonikos database, which is maintained by screening 20 databases, we identified three systematic reviews including 9 randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded that bevacizumab probably decreases time and intraoperative bleeding, but there is uncertainty regarding its effects on visual acuity, and it might increase the risk of cardiovascular events.

La retinopatía diabética proliferativa conlleva un alto riesgo de ceguera si no es tratada de manera oportuna. El tratamiento muchas veces incluye la vitrectomía. El bevacizumab, un anti-factor de crecimiento endotelial vascular, podría disminuir las complicaciones intraoperatorias. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 20 bases de datos, identificamos tres revisiones sistemáticas que en conjunto incluyen 9 estudios aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que bevacizumab probablemente disminuye el tiempo y el sangrado intraoperatorio, pero existe incertidumbre sobre su efecto sobre la agudeza visual y podría aumentar el riesgo de eventos cardiovasculares.

Publication types

  • English Abstract
  • Meta-Analysis

MeSH terms

  • Angiogenesis Inhibitors / administration & dosage
  • Bevacizumab / administration & dosage*
  • Diabetic Retinopathy / pathology
  • Diabetic Retinopathy / surgery*
  • Humans
  • Intraoperative Complications / prevention & control
  • Intravitreal Injections
  • Randomized Controlled Trials as Topic
  • Visual Acuity
  • Vitrectomy / adverse effects
  • Vitrectomy / methods*

Substances

  • Angiogenesis Inhibitors
  • Bevacizumab