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Rivista di Oftalmologia
Minerva Oftalmologica 2017 March;59(1):14-29
Copyright © 2017 EDIZIONI MINERVA MEDICA
Role of anti-VEGF agents for proliferative diabetic retinopathy
Chiya BARRETT 1, Orit BARRETT 2, Noam YANCULOVICH 1, Ran MATLOV KORMAS 1, Jaime LEVY 1 ✉
1 Department of Ophthalmology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Soroka University Medical Center, Israel; 2 Department of Medicine, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
BACKGROUND: Untreated proliferative diabetic retinopathy (PDR) can cause severe visual loss and even blindness. Current treatment of PDR consists of laser panretinal photocoagulation. In recent years, intravitreal injections of anti-vascular endothelial growth factor (VEGF) drugs have been widely used for the treatment of retinal diseases. In this review we summarize the different types of anti-VEGF treatments available for PDR, current treatment regimens, risks, costs and complications.
EVIDENCE ACQUISITION: A comprehensive search was made using PUBMED and Cochrane Central Register of Controlled Trials, with English language articles only included until August 2016 and containing research regarding PDR and anti-VEGF treatments.
EVIDENCE SYNTHESIS: Review of level II studies show that: 1) intravitreal bevacizumab injections previous to vitrectomy cause a reduction in bleeding time during surgery and lower rates of postoperative bleeding; 2) intravitreal ranibizumab injections before vitrectomy showed lower rates of intraoperative bleeding and shorter operating time; 3) intravitreal bevacizumab treatment for neovascular glaucoma is effective in reducing complication rates of Ahmed Valve implantation surgery. Other studies are of level II of evidence or lower.
CONCLUSIONS: Intravitreal bevacizumab and ranibizumab may be helpful in cases of proliferative diabetic retinopathy.
KEY WORDS: Diabetic retinopathy - Endothelial growth factor - Intravitreal injection