In a patient with proliferative diabetic retinopathy (PDR) planning panretinal photocoagulation (PRP), a pre-PRP injection of anti-VEGF (bevacizumab) is most beneficial because:

• A It permanently replaces PRP and prevents disease progression
• B It causes rapid regression of neovascularization, reducing tractional risk from PRP-induced inflammation ✓
• C It reverses macular ischemia and restores foveal vasculature
• D It eliminates the need for vitreous surgery in all tractional detachment cases

Explanation

Pre-procedural anti-VEGF injection causes rapid regression of neovascular tissue (within days), reducing the vascularity of fronds before laser is applied. This decreases the risk of vitreous haemorrhage and contraction of fibrovascular membranes that can be precipitated by PRP-induced inflammation in eyes with active neovascularization. Anti-VEGF is not a permanent replacement for PRP — it requires repeat injections and does not produce the permanent retinal ablation achieved by PRP. It does not reverse established macular ischemia.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.