Bevacizumab is an anti-VEGF drug used in intravitreal injection that is known to cause reversal of sea fan lesions and reduce the duration of vitreous hemorrhage. Intravitreal injection of anti-VEGF drugs can also be used prior to surgery to aid separation of tissues involved in the sea fan lesion and to reduce intraoperative and postoperative hemorrhage. It is useful in combination with photocoagulation. Laser
Indications for laser photocoagulation include
Peripheral neovascularization of upwards of 60° circumference
Sickle cell retinopathy affecting both eyes
Large elevated sea fans
Rapid progression of neovascularizationThere are two methods of photocoagulation mainly used; feeder vessel coagulation and scatter laser coagulation. The first method closes the vessels that supply the neovascularized areas using laser burns. Both the xenon arc and argon laser can be used however, the argon laser carries a reduced risk of complications. In comparison, scatter laser coagulation has an indirect effect. Ischemic retina produces vascular endothelial growth factor (VEGF) which  promotes neovascularization. Scatter laser coagulation destroys this ischemic retina using laser burns thus preventing vitreous hemorrhage, retinal detachment and vision loss. Surgery
Surgical intervention is indicated for severely advanced disease that poses a threat to visual acuity. Indications include longstanding vitreous haemorrhage, vitreous haemorrhage in both eyes, vitreous haemorrhage in patients with only one eye, epiretinal membranes, macular holes and the various forms of retinal detachment. Scleral buckle was a previously popular surgical intervention however, its complications include anterior segment ischemia as a result of vascular occlusion. The vascular occlusion can in turn lead to phthisis bulbi.
Dobutamine is a medication used in the treatment of cardiogenic shock (as  a result of inadequate tissue perfusion) and severe heart failure. It may also be used in certain types of cardiac stress tests. It is given by IV only, as an injection into a vein or intraosseous as a continuous infusion. The amount of medication needs to be adjusted to the desired effect. Onset of effects is generally seen within 2 minutes. It has a half-life of two minutes. This drug is generally only administered short term, although it may be used for longer periods to relieve symptoms of heart failure in patients awaiting heart transplantation.Common side effects include a fast heart rate, an irregular heart beat, and inflammation at the site of injection. Use is not recommended in those with idiopathic hypertrophic subaortic stenosis. It primarily works by direct stimulation of β1 receptors, which increases the strength of the hearts contractions, leading to a positive ionotrophic effect. Generally it has little effect on a persons heart rate.Dobutamine was approved for medical use in the United States in 1978. It is available as a generic medication. It was initially made from isoproterenol. Medical uses
Dobutamine is used to treat acute but potentially reversible heart failure, such as which occurs during cardiac surgery or in cases of septic or cardiogenic shock, on the basis of its positive inotropic action.Dobutamine can be used in cases of congestive heart failure to increase cardiac output.