Objective To evaluate the therapeutic effect of intravitreal injection with bevacizumab (Avastin) (IVB)combined with extra panretinal photocoagulation (E-PRP) for highrisk proliferative diabetic retinopathy (PDR).Methods A total of 57 eyes of 53 patients with highrisk PDR underwent intravitreal injection combined with E-PRP. The examinations of vision acuity, intraocular pressure, iris fluorescein angiography (IFA),fundus photos and fundus fluorescein angiography (FFA) were performed on all of the patients before and 1,2,3,and 6 months after the treatment; the results of the examinations before and after the treatment were compared and analyzed.The average follow up was 6 months.Results The mean visual acuity was (0.143 plusmn;0.072) before the treatment and (0.218 plusmn;0.128) 7 days after the tretment; the difference was significant (t=-7.940, P lt;0.05). The mean visual acuity 1,3,and 6 months after E-PRP (0.228 plusmn;0.138, 0.223 plusmn;0.125,0.220 plusmn;0.134, respectively) differed much from that before IVB (P lt;0.05), but not so much from that after IVB (P gt;0.05).The mean intraocular pressure of 21 eyes which had the neovascularization of pupil margin and iris surface before and 7 days after IVB was (26.632 plusmn;2.629) and (19.316 plusmn;3.092) mm Hg(1 mm Hg=0.133 kPa), respectively; the difference was significant (t=12.838, P lt;0.05) . The mean intraocular pressure 1,3,and 6 months after E-PRP was (16.947 plusmn;2.345),(16.474 plusmn;1.611), and (16.421 plusmn;4.702) mm Hg, respectively, which differed much from that before and after IVB (P lt;0.05). Neovascularization on the disc and the retinae of 57 eyes were subsided partly, and a significant reduction or disappeared of the area of retinal neovascularization and the blood vessel leakage were observed 7 days after IVB. The neovascularization of pupil margin and iris surface of 21 eyes disappeared, and the IFA leakage decreased. The results of FFA 2 months after E-PRP showed that the one-off efficiency of E-PRP was 68.4%;12 eyes (21.1%) needed an additional laser, in which 6 eyes (10.5%) underwent vitreous surgery. Conclusion IVB combined with E-PRP as a treatment for highrisk PDR may improve the regression of retinal neovascularization and the reduction of vascular permeability,and prevent or reduce the complications and improve the therapeutic effect.
Citation： 王丽丽,张雯,李立婕,金丽英,霍敏,何斌. Intravitreal injection with bevacizumab combined with extra panretinal photocoagulation for highrisk proliferative diabetic retinopathy. Chinese Journal of Ocular Fundus Diseases, 2010, 26(2): 116-119. doi: Copy