RESUMEN
BACKGROUND AND OBJECTIVE: To compare intravitreal bevacizumab versus ranibizumab as adjuvant treatment prior to pars plana vitrectomy (PPV) in proliferative diabetic retinopathy (PDR) with respect to parameters of surgical complexity. PATIENTS AND METHODS: Prospective, randomized, double-masked pilot study of patients requiring PPV for nonclearing vitreous hemorrhage or tractional retinal detachment (TRD) secondary to PDR. Patients were randomized to receive either intravitreal bevacizumab or ranibizumab at standard doses 1 week preoperatively. Measured parameters included total surgical time, presence of TRD, intraoperative bleeding, iatrogenic retinal breaks, and use of endolaser and endodiathermy or silicone oil. RESULTS: A total of 29 patients were recruited. For surgical parameters, there were no statistically significant differences between the groups in the univariate analyses. Multivariable analysis showed no statistically significant difference for total surgical time. CONCLUSION: This pilot study suggests that intravitreal bevacizumab and ranibizumab are equivalent as surgical adjuvants when used as pre-treatment in patients with PDR undergoing PPV.
Asunto(s)
Inhibidores de la Angiogénesis/uso terapéutico , Anticuerpos Monoclonales Humanizados/uso terapéutico , Retinopatía Diabética/terapia , Vitrectomía , Adulto , Bevacizumab , Retinopatía Diabética/tratamiento farmacológico , Retinopatía Diabética/cirugía , Método Doble Ciego , Femenino , Hemoglobina Glucada/metabolismo , Humanos , Inyecciones Intravítreas , Masculino , Persona de Mediana Edad , Proyectos Piloto , Estudios Prospectivos , Ranibizumab , Desprendimiento de Retina/tratamiento farmacológico , Desprendimiento de Retina/cirugía , Desprendimiento de Retina/terapia , Equivalencia Terapéutica , Resultado del Tratamiento , Factor A de Crecimiento Endotelial Vascular/antagonistas & inhibidores , Hemorragia Vítrea/tratamiento farmacológico , Hemorragia Vítrea/cirugía , Hemorragia Vítrea/terapiaRESUMEN
OBJECTIVE: To describe the safety and efficacy of very minimal fluence photodynamic therapy (PDT) for chronic central serous chorioretinopathy (CSC). DESIGN: Retrospective case series. PARTICIPANTS: Five patients with chronic CSC. Two had previously failed alternative therapies, and one was taking concomitant corticosteroids. METHODS: Patients were treated with very minimal fluence PDT (12 J/cm(2), 150 mW/cm(2), for 80 seconds). Median follow-up time after PDT was 100 days (range, 51 to 154). RESULTS: All patients experienced an improvement in visual acuity and symptoms, as well as complete resolution of subretinal fluid. CONCLUSIONS: Very minimal fluence PDT appears to be a safe and effective treatment for chronic CSC. Based on these preliminary findings, a randomized controlled trial is warranted.