Importance of Combination of Intravitreal Bevacizumab and Panretinal Photocoagulation in Proliferative Diabetic Retinopathy

Abstract

Introduction: Diabetic retinopathy is a vascular condition of the retina that develops due to diabetes mellitus (DM). This study aimed to compare intravitreal bevacizumab, pan-retinal photocoagulation or a combination of both in proliferative diabetic retinopathy. Method: In this prospective, randomized interventional study, 180 patients with PDR were enrolled and divided into three equal groups, i.e., Group A patients treated with laser alone and group B- patients treated with anti-VEGF alone and Group C- patients treated with anti-VEGF and laser. The patient’s detailed history and clinical and demographical data were recorded and compared. The examination was done, including visual acuity assessment with Snellen’s chart, slit-lamp biomicroscopic examination, Intraocular pressure and pupillary assessment for optic nerve dysfunction. Results: The mean age of group-A, B and C were 57.13 ± 6.88, 55.62 ± 5.97 and 54.86 ± 4.98 were comparable. At the same time, most of the patients were between the age group of 58–66 years [25(41.67%)]. Majority of the patients were male in all three groups. A significant difference was observed in mean FBS and duration of diabetes. In group A and C, most patients affected eye was left [35(58.33%)] and [34(56.67)], respectively, while in group B right eye was affected [33(55.00%)]. The mean VA Log MAR was found to be significant among the three groups. Mean SNELLENS and IOP were insignificant among the groups. At first, follow up the mean VA LOG MAR, SNELLENS, FFA and OCT were found to significant among the groups. At second follow-up, the mean VA LOG MAR was significant. Intragroup analysis between the treatment of the eye was found insignificant, while the rest of the parameters and characteristics were found significant. Conclusion: The present study suggests that the anti-VEGF + PRP were the best treatment regime, followed by anti-VEGF, and PRP was the least effective.