Objective: Intravitreal Bevacizumab (Avastin, Genentech Inc., San Francisco, CA) (IVB) has been shown to cause regression of neovessels in proliferative diabetic retinopathy due to its anti-angiogenic effects. This study was performed to investigate the role of Avastin as an adjunct to the management of patients with proliferative diabetic retinopathy undergoing pars plana vitrectomy.
Methodology: Fifty four eyes of 54 patients with proliferative diabetic retinopathy scheduled for surgery were included in the study. They were randomized to vitrectomy with preoperative IVB (group one) or standard vitrectomy (group 2). Group one underwent a single intravitreal injection of bevacizumab 1.25 mg /0.05ml one week prior to vitrectomy. Main outcome measures were best corrected visual acuity (BCVA) after surgery, post-operative complications.
Results: Mean age of the patients was 52.07±5.54 years (range 39-67). At 6 months, 20 patients in group one had BCVA better than baseline as compared to 12 patients in group 2. In group one, only one patient had early post-operative vitreous hemorrhage, whereas 11 patients in group two had early vitreous hemorrhage.
Conclusion: Preoperative IVB is helpful in improving BCVA post operatively, reducing the time of surgery, decreasing the incidence of intraoperative and postoperative bleeding and reducing the frequency of rubeosis and hyphaema.
Objective: To estimate the effects and safety of suprachoroidal triamcinolone acetonide injections in treating patients with resistant diabetic macular oedema.
Methods: The quasi-experimental study was conducted at the Isra Postgraduate Institute of Ophthalmology, Al-Ibrahim Eye Hospital, Karachi, from November 2019 to March 2020, and adult patients of either gender with uncontrolled diabetes mellitus. Central macular thickness, intraocular pressure and best corrected visual acuity were recorded at baseline, and the patients were followed up at one and three months after the suprachoroidal triamcinolone acetonide injection and post-intervention parameters were compared. Data was analysed using SPSS 20.
Results: There were 60 patients with a mean age of 49.25+/-5.6 years. Of the 70 eyes, 38(54.30%) belonged to male subjects and 32(45.70%) to female subjects. There were significant differences in terms of central macular thickness and the best corrected visual acuity at both follow-ups compared to the baseline readings (p<0.05).
Conclusion: Suprachoroidal triamcinolone acetonide injection significantly reduced diabetic macular oedema.
Key Words: Diabetic macular oedema, Intravitreal, Suprachoroidal, Triamcinolone.
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