%0 Journal Article
%T Use of intravitreal bevacizumab or triamcinolone acetonide as a preoperative adjunct to vitrectomy for vitreous haemorrhage in diabetics Inje  o intrav赤trea de bevacizumabe ou triancinolona como adjuvantes da vitrectomia posterior no tratamento da hemorragia v赤trea em diab谷ticos
%A Daniel Ara迆jo Ferraz
%A Celso Morita
%A Rony Carlos Preti
%A Vinicius Paganini Nascimento
%J Revista Brasileira de Oftalmologia
%D 2013
%I Sociedade Brasileira de Oftalmologia
%X PURPOSE: To evaluate the effect of preoperative intravitreal bevacizumab (IVB) or triamcinolone (IVT) on the rate of early postvitrectomy hemorrhage in proliferative diabetic retinopathy (PDR). METHODS: Eligible eyes were assigned randomly to 1 of 3 groups: the IVB group received 1.25 mg bevacizumab, the IVT group received 4,0mg triamcinolone and the control group underwent a sham procedure. The primary outcome measure was the incidence of early postvitrectomy hemorrhage. Secondary outcome measures included changes in visual acuity (BCVA) and adverse events. RESULTS: Twenty and seven eyes, 9 in each group were randomized. The incidence of vitreous hemorrhage was lower in the IVB group (p=0.18). Postoperative vitreous hemorrhage at 1 month also was less in the IVB group compared with the control group (p > 0.05). The rate of bleeding immediately after surgery was higher in IVT group with 4 (44.4%) cases. The overall mean visual acuity was 1.72 ㊣ 0.37 logMAR preoperatively and 1.32 ㊣ 0.73 logMAR in 6 months after surgery. Accessing visual acuity by group evidenced that the IVB group had initial mean logMAR VA of 1.87 and 1.57 logMAR VA at the six months (p = 0.84). In IVT group, initial mean VA was 1.75 logMAR and 0.96 logMAR VA at six months (p < 0.001). And in control group, the initial mean VA was 1.85 logMAR and 1.57 logMAR VA at six months (p= 0.34). CONCLUSION: Intravitreal injection of bevacizumab 1 week before vitrectomy seems to reduce the incidence of early postvitrectomy hemorrhage in diabetic patients. There was a better visual acuity outcome in the triamcinolone group. OBJETIVO: Avaliar o efeito no pr谷-operat車rio da injecao intrav赤trea de bevacizumab (IVB) ou triancinolona (IVT) sobre a taxa de hemorragia precoce pos-vitrectomia na retinopatia diab谷tica proliferativa. M谷TODOS: Os olhos foram distribu赤dos em tr那s grupos: IVB - 1,25 mg bevacizumab, IVT - 4,0 mg de triancinolona e o grupo controle - simula  o da inje  o. O objetivo prim芍rio foi a avalia  o da incid那ncia da hemorragia precoce p車s-vitrectomia. Os objetivos secund芍rios inclu赤ram mudan as na acuidade visual corrigida e eventos adversos relacionados 角 inje  o. RESULTADOS: Dos Vinte e sete olhos, 9 foram randomizados em cada grupo. A incid那ncia de hemorragia v赤trea foi menor no grupo IVB (P=0,18). A hemorragia v赤trea em 1 m那s tamb谷m foi menor no grupo IVB (P > 0,05). A taxa de sangramento p車s-operat車rio imediato foi maior no grupo IVT com 4 (44,4%) dos casos. A m谷dia da acuidade visual (AV) foi de 1,72 ㊣ 0,37 logMAR no pr谷-operat車rio e 1,32 ㊣ 0,73 logMAR em 6 meses ap車s a cirurgia. An
%K Retinopatia diab谷tica
%K Vitrectomia
%K Inibidores da angiog那nese
%K Bevacizumabe
%K Triancinolona
%K Acuidade visual
%K Diabetic retinopathy
%K Vitrectomy
%K Angiogenesis inhibitors
%K Triamcinolone
%K Visual acuity
%U http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-72802013000100003