Session Title: Quick Fire Free Paper Session 02
Session Date/Time: Thursday 26/09/2013 | 14:30-16:00
Paper Time: 15:50
Venue: Hall G1 (Level 2)
First Author: A.El Barky UNITED ARAB EMIRATES
Combined intravitreal Ranibizumab injection with Pars plana vitrectomy versus Pars plana vitrectomy for treatment of longstanding vitreous hemorrhage in diabetic patients
Sheikh Khalifa Medical City UAE
Cases included in this clinical trial were diabetic patients diagnosed with chronic vitreous hemorrhage more than 3 months in duration. Forty patients were included in this study and were divided into two groups; group A which includes 20 patients who received intravitreal Ranibizumab injection with pars plana vitrectomy and group B which includes 20 patients who had undergone pars plana vitrectomy without Ranibizumab injection. B-scan was done for all patients to rule out tractional retinal detachment or extensive fibrovascualr membranes as those patients were excluded from the study. At baseline all patients had best corrected visual acuity (BCVA) on decimal scale and intraocular pressure (IOP) measurement by applanation tonometry. Follow-up visits were done at 1, 3 and 6 months subsequent to the surgical procedure where BCVA, IOP, Fundus biomicroscopy were assessed. Fluorescein angiography (FA) was done for all patients at the same follow-up visits to diagnose leaking neovascularization elsewhere (NVE) or new neovascularization at the disc (NVD).The incidence or recurrent vitreous hemorrhage was reported and compared between both groups.
Of 40 patients, 24 (60%) were men and 16 (40%) were women with a mean age of 65.6 ± 3.9 years. The mean best-corrected visual acuity measurements improved significantly (P<0.001), in both groups, from counting fingers to a final best-corrected visual acuity of 0.7 postoperatively. Throughout the follow-up period, seven patients (35%) in group B had recurrent vitreous hemorrhage while group A shows no cases of recurrent vitreous hemorrhage. Fluorescein angiography shows no leaking NVE or NVD in group A, while six patients (30%) from group B show leaking NVDs and three (15%) patients show leaking NVEs.
Intravitreal Ranibizumab injection is a useful adjunct when combined with pars plana vitrectomy, for the treatment of VH in diabetic patients, as it significantly reduces the incidence of recurrent postoperative hemorrhage through regression of neovascularization and improved retinal blood vessels integrity.