Efficacy of Intravitreal Bevacizumab Injection for Proliferative Diabetic Retinopathy with Vitreous Hemorrhage at Nongkhai Hospital

Objective: To evaluate the effectiveness of intravitreal bevacizumab (IVB) injection in vitreous hemorrhage (VH) due to proliferative diabetic retinopathy (PDR). Materials and Methods: A retrospective cohort study was performed by reviewing medical charts at Nongkhai Hospital between October 1, 2019 and February 28, 2022. VH in PDR patients was divided into two groups as IVB and observation. Complete ophthalmic examination and/or ocular ultrasonography were performed at baseline and at 4, 8, and 12 weeks. The main outcome, as the success rate of vitrectomy at 12 weeks, and the secondary outcome as mean change in best-corrected visual acuity (BCVA) were recorded. Results: There were no significant differences among 73 consecutive patients, with 76 eyes, with VH due to PDR between the IVB injection and the observation groups with respect to gender, age, BMI, type of diabetes, hypertension, dyslipidemia, and BCVA at baseline, and no statistically significant differences in pars plana vitrectomy (PPV) rate between the IVB and the observation groups at 5.40% versus 13.50% (p=0.22). A statistically significant improvement in mean BCVA change was recorded from the baseline to the 12-week follow-up visit as 29.70±2.78 letters in the IVB group compared with 20.17±2.73 letters in the observation group (p=0.02). Complete panretinal photocoagulation (PRP) treatment was performed at 71.4% in the IVB group and 58.1% in the observation group in one visit. Conclusion: IVB injection in patients suffering from PDR with VH reduced the need for vitrectomy. Results suggested no clinically important differences between the IVB and the observation groups on the rate of vitrectomy. IVB injection rapidly improved BCVA and reduced the number of patient follow-up visits required to achieve full PRP. Keywords: Bevacizumab; Proliferative diabetic retinopathy; Vitreous hemorrhage; Retinal neovascularization