Intravitreal bevacizumab injection for recurrent vitreous haemorrhage after diabetic vitrectomy

Abstract

Purpose: To evaluate the efficacy of intravitreal bevacizumab in treating recurrent vitreous haemorrhage (VH) after diabetic vitrectomy.

Methods: Consecutive patients with postoperative recurrent VH ≥ 2 weeks after primary diabetic vitrectomy were treated with intravitreal bevacizumab. Repeated injection was given after 2-3 weeks in case of no obvious blood reabsorption (study group). Consecutive patients with the same complication but without bevacizumab injection served as the control group. Vitreous surgeries in both groups were indicated if no clinical improvement was noted 10-12 weeks after the initial bleeding. Vitreous clear-up time (VCT), vitreous surgeries and rebleeding rates, and visual acuity changes were compared between both groups.

Results: The study group had 20 eyes (20 patients) and the control group had 18 eyes (18 patients). Postoperative VH occurred between 1 and 25 months and between 1 and 18 months, respectively. In the study group, VCT after the first recurrent VH was 6.5 ± 1.5 weeks with 2.2 ± 0.8 injections. Nine cases had ≥ one episode of VH, but no surgery was needed. In the control group, 13 eyes had spontaneous re-absorption (in 6.4 ± 1.3 weeks); five eyes underwent surgeries; three of the 13 eyes eventually had surgeries after further recurrent VH. The rate of vitreous surgery in the two groups was 0/20 and 8/18 (p = 0.01). The total number of rebleeding was 30 in the study group and 27 in the control group (p = 0.69).

Conclusion: Intravitreal bevacizumab treatment may reduce the need of revitrectomy for recurrent vitreous haemorrhage after diabetic vitrectomy.