Intravitreal Bevacizumab in the Surgical Treatment of Proliferative Diabetic Retinopathy

T R E ATM E N T O F PD R In 2005, after our initial encouraging experience with intravitreal bevacizumab for age-related macular degeneration, I began to use it in patients with rubeosis. The first patient I treated presented with bilateral neovascularization, rubeosis in the right eye, and partial vitreous hemorrhage in the left eye.1 I applied panretinal photocoagulation (PRP) for the left eye, and on the same day I injected bevacizumab into the right eye. Within 1 week, the neovascularization of the iris, nerve head, and posterior pole stopped leaking in the right eye, and the areas of nonperfusion looked smaller. Presenting this case at the American Academy of Ophthalmology meeting in 2005,2 I proposed a number of potential roles for intravitreal bevacizumab in patients with PDR. These include treatment of rubeosis, persistent neovascularization despite PRP, vitreous hemorrhage precluding PRP, PDR associated with diabetic macular edema, and as an injection before vitrectomy to reduce bleedIntravitreal Bevacizumab in the Surgical Treatment of Proliferative Diabetic Retinopathy