Timing of neovascular regression in eyes with high-risk proliferative diabetic retinopathy without macular edema treated initially with intravitreous bevacizumab

Faiz I Shakarchi,1,2 Ahmed F Shakarchi,3 Shadha A Al-Bayati2 1Department of Ophthalmology, Al-Mustansiriya University – College of Medicine, Baghdad, Iraq; 2Vitreoretinal Department, Ibn Al-Haetham Teaching Eye Hospital, Baghdad, Iraq; 3Baghdad Teaching Hospital, Baghdad, Iraq Purpose: T...

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Autores principales:	Shakarchi FI, Shakarchi AF, Al-Bayati SA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	Proliferative diabetic retinopathy anti-VEGF Bevacizumab Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/dd332afe76d547c49d26b06c4d739fd8
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spelling	oai:doaj.org-article:dd332afe76d547c49d26b06c4d739fd82021-12-02T05:25:38ZTiming of neovascular regression in eyes with high-risk proliferative diabetic retinopathy without macular edema treated initially with intravitreous bevacizumab1177-5483https://doaj.org/article/dd332afe76d547c49d26b06c4d739fd82018-12-01T00:00:00Zhttps://www.dovepress.com/timing-of-neovascular-regression-in-eyes-with-high-risk-proliferative--peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Faiz I Shakarchi,1,2 Ahmed F Shakarchi,3 Shadha A Al-Bayati2 1Department of Ophthalmology, Al-Mustansiriya University – College of Medicine, Baghdad, Iraq; 2Vitreoretinal Department, Ibn Al-Haetham Teaching Eye Hospital, Baghdad, Iraq; 3Baghdad Teaching Hospital, Baghdad, Iraq Purpose: To determine the timing of neovascular regression after intravitreous injection of bevacizumab (Avastin®) 1.25 mg given as initial therapy for eyes with high-risk proliferative diabetic retinopathy (PDR) without clinically significant macular edema (CSME). Patients and methods: In this prospective uncontrolled interventional study, eyes with high-risk PDR without CSME were treated initially with intravitreous injections of bevacizumab 1.25 mg given every 4 weeks until no neovessels were detected, followed by standard pan-retinal photocoagulation (PRP). Patients were examined 48 hours, 1, 2, and 4 weeks after each injection to determine the status of neovascularization. Results: Twenty-one patients (24 eyes) were included in the study. Forty-eight hours after the first injection of bevacizumab, we observed complete neovascular regression in 20 (83%) eyes. Neovascular regression was maintained in the same number of eyes in the first 2 weeks. At 4 weeks, three eyes displayed neovascular recurrence, and a second injection of bevacizumab was given to the seven eyes with persistent or recurrent neovascularization. Complete neovascular regression was observed in six (86%) eyes after 48 hours and was maintained for 2 weeks following the second bevacizumab injection. Two eyes required a third injection and had complete neovascular regression when assessed after 48 hours and 4 weeks. Conclusion: The majority of neovessels completely regressed within 48 hours after intravitreous injection of bevacizumab given as initial therapy for high-risk PDR without CSME. The full neovascular regressive effect occurred within 48 hours and was maintained for at least 2 weeks. Keywords: proliferative diabetic retinopathy, anti-vascular endothelial growth factor (anti-VEGF), bevacizumabShakarchi FIShakarchi AFAl-Bayati SADove Medical PressarticleProliferative diabetic retinopathyanti-VEGFBevacizumabOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 13, Pp 27-31 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Proliferative diabetic retinopathy anti-VEGF Bevacizumab Ophthalmology RE1-994
spellingShingle	Proliferative diabetic retinopathy anti-VEGF Bevacizumab Ophthalmology RE1-994 Shakarchi FI Shakarchi AF Al-Bayati SA Timing of neovascular regression in eyes with high-risk proliferative diabetic retinopathy without macular edema treated initially with intravitreous bevacizumab
description	Faiz I Shakarchi,1,2 Ahmed F Shakarchi,3 Shadha A Al-Bayati2 1Department of Ophthalmology, Al-Mustansiriya University – College of Medicine, Baghdad, Iraq; 2Vitreoretinal Department, Ibn Al-Haetham Teaching Eye Hospital, Baghdad, Iraq; 3Baghdad Teaching Hospital, Baghdad, Iraq Purpose: To determine the timing of neovascular regression after intravitreous injection of bevacizumab (Avastin®) 1.25 mg given as initial therapy for eyes with high-risk proliferative diabetic retinopathy (PDR) without clinically significant macular edema (CSME). Patients and methods: In this prospective uncontrolled interventional study, eyes with high-risk PDR without CSME were treated initially with intravitreous injections of bevacizumab 1.25 mg given every 4 weeks until no neovessels were detected, followed by standard pan-retinal photocoagulation (PRP). Patients were examined 48 hours, 1, 2, and 4 weeks after each injection to determine the status of neovascularization. Results: Twenty-one patients (24 eyes) were included in the study. Forty-eight hours after the first injection of bevacizumab, we observed complete neovascular regression in 20 (83%) eyes. Neovascular regression was maintained in the same number of eyes in the first 2 weeks. At 4 weeks, three eyes displayed neovascular recurrence, and a second injection of bevacizumab was given to the seven eyes with persistent or recurrent neovascularization. Complete neovascular regression was observed in six (86%) eyes after 48 hours and was maintained for 2 weeks following the second bevacizumab injection. Two eyes required a third injection and had complete neovascular regression when assessed after 48 hours and 4 weeks. Conclusion: The majority of neovessels completely regressed within 48 hours after intravitreous injection of bevacizumab given as initial therapy for high-risk PDR without CSME. The full neovascular regressive effect occurred within 48 hours and was maintained for at least 2 weeks. Keywords: proliferative diabetic retinopathy, anti-vascular endothelial growth factor (anti-VEGF), bevacizumab
format	article
author	Shakarchi FI Shakarchi AF Al-Bayati SA
author_facet	Shakarchi FI Shakarchi AF Al-Bayati SA
author_sort	Shakarchi FI
title	Timing of neovascular regression in eyes with high-risk proliferative diabetic retinopathy without macular edema treated initially with intravitreous bevacizumab
title_short	Timing of neovascular regression in eyes with high-risk proliferative diabetic retinopathy without macular edema treated initially with intravitreous bevacizumab
title_full	Timing of neovascular regression in eyes with high-risk proliferative diabetic retinopathy without macular edema treated initially with intravitreous bevacizumab
title_fullStr	Timing of neovascular regression in eyes with high-risk proliferative diabetic retinopathy without macular edema treated initially with intravitreous bevacizumab
title_full_unstemmed	Timing of neovascular regression in eyes with high-risk proliferative diabetic retinopathy without macular edema treated initially with intravitreous bevacizumab
title_sort	timing of neovascular regression in eyes with high-risk proliferative diabetic retinopathy without macular edema treated initially with intravitreous bevacizumab
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/dd332afe76d547c49d26b06c4d739fd8
work_keys_str_mv	AT shakarchifi timingofneovascularregressionineyeswithhighriskproliferativediabeticretinopathywithoutmacularedematreatedinitiallywithintravitreousbevacizumab AT shakarchiaf timingofneovascularregressionineyeswithhighriskproliferativediabeticretinopathywithoutmacularedematreatedinitiallywithintravitreousbevacizumab AT albayatisa timingofneovascularregressionineyeswithhighriskproliferativediabeticretinopathywithoutmacularedematreatedinitiallywithintravitreousbevacizumab
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Timing of neovascular regression in eyes with high-risk proliferative diabetic retinopathy without macular edema treated initially with intravitreous bevacizumab

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