Intravitreal bevacizumab for vitreous hemorrhage

Abstract Purpose Vitreous hemorrage is one of the major complications of ischemic retinopathies such as diabetic retinopathy. Our purpose was to describe the clinical outcome of patients who underwent a less invasive intervention than vitrectomy for therapy of persisting vitreous hemorrage Methods Our clinical interventional case series study included 10 patients (n=11 eyes) who presented with vitreous hemorrage due to proliferative diabetic retinopathy (n=10 eyes)or ischemic retinal vein occlusions (n=1). The hemorrage had persisted for at least 3 months. Mean age was 62,1+/‐14,5 years (median 58.4 years; range 45.8‐90.8 years) and mean visual acuity was 1,65+/‐0.97 logMAR. The mean intraocular pressure was 14.6+/‐3.6 mm Hg. All eyes received an intravitreal injection of 1.25 mg bevacizumab, which was repeated in 2 eyes (17%). All patients were fully informed about the experimental character of the treatment and signed an informed consent. Results At the end of follow‐up at 3.9+/‐2.3 months (range 1‐6 months) after the first injection, the vitreous hemorrage had cleared without any further intervention in all but 1 (9%) eye. Visual acuity improved significantly (p=0.02) from 1.65+/‐0.97 logMAR to 0.98+/‐0.67 logMAR. The intraocular pressure remained in the normal range (mean 14.6+/‐3.5 mm Hg) with no significant difference to the baseline values (p=0.94). We did not observe any sign of intraocular inflammation or other changes that could be regardesd as side‐effects of the intravitreal injecion. 4 (36%) eyes underwent panretinal laser coagulation after clearing of the vitreous hemorrage. Conclusion The present study may suggest to extend the intravitreal use of bevacizumab to persisting vitreous hemorrage due to ischemic retinopathies.