Randomized 3-armed trial of intravitreal bevacizumab vs laser vs combination of bevacizumab and modified laser in PDR
Alireza Ramezani1 *, Ramin Nourinia1 , Toktam Shahraki1 , Amir Arabi1 , Nazanin Fatemeh Beheshtizadeh1 , Morteza Entezari1 , Homayoun Nikkhah1 , Saeed Karimi1
- SHAHID BEHESHTI UNIVERSITY OF MEDICAL SCIENCES, Tehran, Iran, Islamic Republic Of
Abstract: To compare the therapeutic effect of IVB alone vs. PRP alone vs. combination of IVB and modified photocoagulation on PDR
Methods: Sixty eyes with PDR were included and divided randomly into 3 groups: IVB group that received 4 monthly IVB injections and then rescue IVB, PRP group that underwent full PRP in 2 or 3 sessions and then rescue IVB, and combination group that received 2 bimonthly IVB injections and a modified laser and then rescue IVB or laser. Primary outcome was the number and activity of neovascularizations at 8 months and secondary measures were changes in best corrected visual acuity (BCVA) and central macular thickness (CMT), and number of examinations and injections
Results: The extent of neovascularizations decreased significantly in all groups from 12±11, 9±9, and 8±6 to 5±6, 3±3, and 4±4 disc area at month 8 in the IVB, PRP, and combination groups, respectively (P<0.001); however, the difference among the groups was not meaningful (P=0.69). Numbers of IVB injections up to the month 8 (5±1, 2±1, and 4±1 in the IVB, PRP, and combination groups, respectively) were significantly different among the groups (P<0.001); nevertheless, the corresponding number of examinations were insignificant (3±1, 3±1, and 3±1, P=0.56).
Conclusion: Since the numbers of injections and laser treatments were different among the protocols, the recommended treatment could be chosen according to patients’ compliances
