Bevacizumab presurgical treatment for proliferative sickle-cell retinopathy-related retinal detachment

To report the use of presurgical intravitreal bevacizumab in the context of proliferative sickle-cell retinopathy with retinal detachment.

Intravitreal bevacizumab was injected 3 days before the surgical procedure for traction retinal detachment. Vitrectomy, membrane peeling, endolaser, and SF6 gas tamponade were performed. A 37-year-old African American woman presented with hemoglobin sickle-cell disease and temporal retinal detachment with bullous subretinal fluid extending through the fovea associated with an area of active sea-fan retinal neovascularization with preretinal hemorrhage and retinal traction, with 3 associated retinal breaks.

The sea-fan neovascularization associated with the traction retinal detachment and the resultant retinal breaks appeared more fibrotic and les vascular than was noted prior to the pre-operative bevacizumab injection. Segmentation and dissection were performed with minimal bleeding, and retinal traction was relieved without difficulty. This was believed to be atypical in the experience of the surgeons. One month postoperatively, vision measured 20/50, and the retina remained attached.

Further study is necessary to clarify the role of anti-vascular endothelial growth factor in the treatment of proliferative sickle cell retinopathy associated retinal detachment.