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Dramatic Response of Iris and Retinal Neovascularisation Following Usage of Intravitreal Ranibizumab as Pre-operative Adjunct in Vitrectomy for Advanced Proliferative Diabetic Retinopathy

Case reports

Abstract

A  37-year-old  Malay  woman  presented  with  progressive  deterioration  in vision  and  was  diagnosed  with advanced proliferative  diabetic  retinopathy  with  neovascular  glaucoma.  Intravitreal  ranibizumab  injection  (an  anti-vascular endothelial growth factor) was administered prior to vitrectomy. Slit lamp assessment 2 days post-injection revealed significant regression of both iris and retinal neovascularisation. This resulted in adequate reduction of intra-ocular pressure  prior  to  surgery.  In  addition,  the  regression  of  retinal  vessels  reduced  the  risk  of  intra-operative haemorrhage, thus aiding the surgical excision of the fibrovascular membranes. Periodic post-operative assessment in the first 3 weeks showed minimal inflammation and no recurrence of vitreous haemorrhage. This case illustrates that intravitreal ranibizumab has a role as an adjunct therapy prior to diabetic vitrectomy to significantly reduce the risk of intra-ocular haemorrhage.