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Evidence summaries

Bevacizumab to Prevent Haemorrhage after Vitrectomy for Proliferative Diabetic Retinopathy

Preoperative use of bevacizumab in diabetic vitrectomy appears to reduce the incidence of early postoperative vitreous cavity haemorrhage. Level of evidence: "B"

Comment: The quality of evidence is downgraded by study limitations (lack of blinding).

Summary

A Cochrane review [Abstract] 1 on perioperative use of anti-vascular endothelial growth factor (anti-VEGF) for prevention of postoperative vitreous cavity haemorrhage (POVCH) after vitrectomy for proliferative diabetic retinopathy included 28 studies with a total of 1914 eyes.

Participants receiving intravitreal bevacizumab in addition to pars plana vitrectomy were less likely to experience early POVCH compared to people undergoing pars plana vitrectomy alone (RR 0.44, 95% CI 0.34 to 0.58; 14 studies, 1038 eyes). Similar results were seen for late POVCH (RR 0.47, 95% CI 0.30 to 0.74; 11 studies, 579 eyes).

Participants receiving intravitreal anti-VEGF in addition to pars plana vitrectomy achieved better best corrected visual acuity at 6 months compared to people undergoing vitrectomy alone (mean difference (MD) -0.25 logMAR, 95% CI -0.39 to -0.11; 13 studies, 699 eyes; low-certainty evidence).

Clinical comments

Note

Date of latest search: 2023-10-23

References

  • Dervenis P, Dervenis N, Smith JM et al. Anti-vascular endothelial growth factors in combination with vitrectomy for complications of proliferative diabetic retinopathy. Cochrane Database Syst Rev 2023;5(5):CD008214. [PubMed]

Primary/Secondary Keywords