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Comparative evaluation of conventional (pars plana vitrectomy) versus intravitreal bevacizumab assisted treatment for non-resolving vitreous hemorrhage (NRVH) in Eales’ disease

Session Details

Session Title: Miscellaneous

Session Date/Time: Saturday 13/09/2014 | 11:00-13:00

Paper Time: 11:48

Venue: Boulevard E

First Author: : P.Jain INDIA

Co Author(s): :    M. Thakar   U. Kaul Raina   B. Ghosh   G. Bhushan     

Abstract Details

Purpose:

This study investigated the efficacy of intravitreal bevacizumab in non-resolving vitreous hemorrhage in terms of resolution of hemorrhage and intraoperative assistance

Setting:

A Prospective Interventional study was conducted in Vitreo-retina department of Guru Nanak Eye centre, Delhi after taking clearance from Institutional Ethical committee

Methods:

29 patients of Eales’ disease presenting with Non-resolving vitreous hemorrhage were enrolled and randomly divided into 2 groups. A written informed consent was taken from all the patients. Group I consisted of 14 patients, who received intravitreal Bevacizumab (1.25 mg in 0.05 ml) and followed up next day and at 4 weeks. At the end of 4 weeks, the resolution of vitreous hemorrhage (VH) was noted. If the VH resolved, laser photocoagulation (frequency doubled Nd-Yag) was done and if VH persisted, hybrid 20 G-23 G pars plana vitrectomy (PPV) with endolaser was done. Group II was the control group and consisted of 15 patients who underwent pars plana vitrectomy with endolaser. In both the groups the follow up was at 2 weeks and 4 weeks post laser/ PPV with endolaser. The follow up was of 1 month duration. In both the groups, intraoperatively, a note was made of intraoperative ooze and need of hemostatic measures (increased bottle height / diathermy) on cutting the fibrovascular fronds. At each follow up visit, the parameters evaluated were best corrected visual acuity (BCVA), Intraocular pressure and indirect ophthalmoscopy

Results:

All the patients were in the range of 20-30 years. Both the groups were comparable in terms of age distribution, sex distribution, duration of vitreous hemorrhage and mean BCVA at presentation. In Group I at 4 weeks, resolution of VH was noted in 6 patients, in whom laser was done and 8 patients underwent PPV. On Intraoperative evaluation, intraoperative ooze was noted in 1 patient in Group I and 5 patients in Group II with difference being non-significant (p=0.27). Similarly the difference in requirement of subsequent hemostatic measures was non-significant (p=0.27). In 6 patients in Group I who underwent laser, there was a significant change in BCVA at 2 weeks (p= 1.862) and 4 weeks (p=1.862). In 8 patients in Group I who underwent PPV, there was a significant change in BCVA at 2 weeks (p=2.16) and 4 weeks (p=2.16). In Group II there was a significant change in BCVA at 2 weeks (p=2.42) and 4 weeks (2.42). The difference in BCVA of both the groups was not statistically different at 4 weeks (p=0.521)

Conclusions:

The use of intravitreal Bevacizumab not only result in resolution of vitreous hemorrhage thus avoiding surgery and its inherent complications but also assists surgery in terms of less intraoperative ooze and less hemostatic measures required, thus saving time

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