Intravitreal injection of bevacizumab and gas for diabetic premacular hemorrhage with active fibrovascular proliferation

Background: To report the effect of intravitreal injection of bevacizumab and gas for the treatment of diabetic premacular hemorrhage with active fibrovascular proliferation. Methods: Six eyes of six consecutive patients with acute diabetic premacular hemorrhage and active fibrovascular proliferation received intravitreal injection of bevacizumab (1.25 mg in 0.05 mL) and C3F8 (0.2-0.3 mL) during the same setting. All six cases had panretinal photocoagulation prior to the procedure. After treatment, patients maintained a prone position for 3 days and were followed for an average of 8 months (range, 4-13 months). Results: All six eyes had complete reabsorption of the hemorrhage and reduction of fibrovascular proliferation. Transient vitreous opacification from breakthrough of the blood were observed in all eyes. An average of 3.8 weeks (range, 1-6 weeks) was required for the clearing of preretinal hemorrhage. Visual acuity improved in all six eyes. No recurrent bleeding or other adverse events were encountered in all cases. Conclusions: Intravitreal injection of bevacizumab and gas may be an effective method for treating acute diabetic premacular hemorrhage with active fibrovascular proliferation.