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Pre- and Intra-operative Intravitreal Bevacizumab Injection in Diabetic Vitrectomy

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Seoul National University Bundang Hospital

Mots clés

Abstrait

The purpose of this study is to determine the effect of pre- and intra-operative bevacizumab injection on postoperative vitreous hemorrhage after diabetic vitrectomy.

La description

Postoperative vitreous hemorrhage(VH) is a common complication after vitrectomy for proliferative diabetic retinopathy. Persistent or recurrent VH can delay visual rehabilitation and give patients much trouble. There have been efforts to lower the incidence of postoperative VH such as using intraoperative gas tamponade and preoperative bevacizumab injection. Bevacizumab(Avastin) is a potent inhibitor of angiogenesis and has been shown to decrease retinal and iris neovascularization in proliferative diabetic retinopathy. Recently there have been reports showing that preoperative intravitreal bevacizumab (IVB) injection could reduce intraoperative bleeding from abnormal vessels and could make surgery easier and more successful.Our hypothesis is that preoperative bevacizumab injection could reduce postoperative VH by way of decreasing the amount of abnormal vessels and intraoperative injection could also reduce postoperative VH by inhibiting the vessel formation after surgery.

To prove our hypothesis, we started the prospective randomized comparative study to determine the effect of pre- and intra-operative IVB injection on postoperative vitreous hemorrhage after diabetic vitrectomy.

Rendez-vous

Dernière vérification: 10/31/2015
Première soumission: 09/01/2008
Inscription estimée soumise: 09/01/2008
Première publication: 09/02/2008
Dernière mise à jour soumise: 11/16/2015
Dernière mise à jour publiée: 12/20/2015
Date des premiers résultats soumis: 06/05/2012
Date de la première soumission des résultats du CQ: 11/16/2015
Date des premiers résultats publiés: 12/20/2015
Date de début réelle de l'étude: 05/31/2008
Date d'achèvement primaire estimée: 09/30/2010
Date estimée d'achèvement de l'étude: 09/30/2010

Condition ou maladie

Proliferative Diabetic Retinopathy
Vitreous Hemorrhage

Intervention / traitement

Drug: Bevacizumab

Phase

-

Groupes d'armes

BrasIntervention / traitement
Experimental: Preop IVB
Patients will receive intravitreal injection of 1.25 mg of bevacizumab (0.05 ml) 1 to 14 days before vitrectomy
Experimental: Intraop IVB
Patients will receive intravitreal injection of 1.25 mg of bevacizumab (0.05 ml) at the end of vitrectomy
No Intervention: No IVB
Patients will not receive bevacizumab before nor during vitrectomy

Critère d'éligibilité

Âges éligibles aux études 20 Years À 20 Years
Sexes éligibles à l'étudeAll
Accepte les bénévoles en santéOui
Critères

Inclusion Criteria:

- Patients undergoing first vitrectomy for complications of proliferative diabetic retinopathy such as vitreous hemorrhage, tractional fibrovascular membrane proliferation, tractional or combined retinal detachment)

Exclusion Criteria:

- Follow-up period of less than 6 months

- Intraoperative use of long-acting gas or silicone oil

- Repeat vitrectomy after first vitrectomy for diseases other than vitreous hemorrhage

- Not first vitrectomy

- Uncontrolled hypertension

- Medical history of abnormal blood coagulation

- Time interval between IVB injection and PPV longer than 2 weeks and recent history (within 3 months) of IVB treatment

Résultat

Mesures des résultats primaires

1. Recurrent VH Incidence (Early and Late) [6 months]

Recurrent VH was defined as a new episode of grade 1 or more VH occurring more than 1 week after surgery. "Early recurrent VH" was VH occurring <= 4 weeks and "late recurrent VH" was VH occurring >4 weeks after surgery.

Mesures des résultats secondaires

1. Initial Time of Vitreous Clearing (ITVC) [6 months]

The interval in number of days for VH of grade 1 or more observed at postoperative day 1 to clear-up completely. VH of grade 1 was defined as mild vitreous hemorrhage with visible fundus details, but difficult to evaluate the retinal nerve fiber layer or small vessels.

2. Visual Outcome [6 months]

Best-corrected visual acuity (BCVA) at postoperative 6 months

3. Postoperative Resolution of Neovascularization [6 months]

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