Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.
Eye and Ear University Hospital, Ophthalmology Department, Naccash, Lebanon.
Retina. 2018 Jun;38(6):1127-1133. doi: 10.1097/IAE.0000000000001673.
To investigate the efficacy of intravitreal ranibizumab injections in proliferative diabetic retinopathy associated with vitreous hemorrhage (VH).
A prospective study including patients with proliferative diabetic retinopathy who presented with persistent VH. Vitreous hemorrhage was graded into mild, moderate, and severe. Patients were randomized into two groups: the ranibizumab group was treated with intravitreal injections of ranibizumab and the control group was assigned to observation alone. Vitrectomy was performed if there was any aggravation of the VH in patients with mild, moderate, and severe VH or in the absence of improvement by 16 weeks in patients with moderate and severe VH.
The ranibizumab group included 71 patients and the control group included 62 patients. There was a statistically significant difference in the vitrectomy rate in patients with mild-to-moderate VH (5 patients [7.04%] and 12 patients [19.35%], respectively; P = 0.04). However, there was no statistically significant difference in the overall vitrectomy rate, and in the vitrectomy rate in severe VH (17 [23.94%] and 12 [16.90%] patients in the ranibizumab group vs. 22 [35.48%] and 10 [16.13%] patients in the control group, P = 0.14 and P = 0.83, respectively). Recurrence of the VH occurred in 22 patients in the ranibizumab group and 29 patients in the control group (P = 0.06). Better visual acuity measurements were recorded on all follow-up visits in the ranibizumab group (P ≤ 0.04).
Intravitreal ranibizumab injections could be considered in proliferative diabetic retinopathy patients with mild and moderate VH.
研究玻璃体积血(VH)相关增生性糖尿病视网膜病变患者玻璃体内注射雷珠单抗的疗效。
本前瞻性研究纳入了增生性糖尿病视网膜病变伴持续性 VH 的患者。VH 分为轻度、中度和重度。患者随机分为两组:雷珠单抗组接受玻璃体内注射雷珠单抗治疗,对照组仅接受观察。如果轻度、中度和重度 VH 患者的 VH 加重或中度和重度 VH 患者在 16 周内无改善,则进行玻璃体切除术。
雷珠单抗组包括 71 例患者,对照组包括 62 例患者。轻度至中度 VH 患者的玻璃体切除术率存在统计学差异(分别为 5 例[7.04%]和 12 例[19.35%];P=0.04)。然而,总体玻璃体切除术率和重度 VH 患者的玻璃体切除术率无统计学差异(雷珠单抗组分别为 17 例[23.94%]和 12 例[16.90%],对照组分别为 22 例[35.48%]和 10 例[16.13%];P=0.14 和 P=0.83)。雷珠单抗组有 22 例患者和对照组有 29 例患者 VH 复发(P=0.06)。雷珠单抗组在所有随访时的视力测量均更好(P≤0.04)。
玻璃体内注射雷珠单抗可考虑用于轻度和中度 VH 的增生性糖尿病视网膜病变患者。