Chen Lishuang, Qu Linghui, Gui Qian, Wang Sangsang, Mao Jinghai, Fu Xiangxiang, Li Wendie, Wang Yanyan, Yi Quanyong
Department of Ophthalmology, Ningbo Eye Hospital, Zhejiang, China.
Department of Ophthalmology, The 74th Army Group Hospital, Guangzhou, China.
J Ocul Pharmacol Ther. 2021 Dec;37(10):591-596. doi: 10.1089/jop.2021.0039. Epub 2021 Oct 22.
To compare the clinical effects of postoperative versus perioperative injection of anti-vascular endothelial growth factor (VEGF) drugs before and after pars plana vitrectomy (PPV) in patients with vitreous hemorrhage secondary to polypoidal choroidal vasculopathy (PCV). This was a retrospective study of patients who underwent PPV due to vitreous hemorrhage between October 2013 and June 2019 at Ningbo Eye Hospital. The patients who underwent PPV surgery due to PCV-secondary vitreous hemorrhage were included. The primary outcome was the changes in best-corrected visual acuity. The secondary outcome was the central macular thickness. Compared with the postoperative group ( = 20), the perioperative group ( = 18) showed a smaller number of postoperative anti-VEGF injections (5.1 ± 0.8 vs. 8.0 ± 1.5, < 0.05) and lower frequencies of early hyphema (5.6% vs. 30.0%, < 0.05), and recurrent vitreous hemorrhage (11.1% vs. 30.0%, < 0.05). The logarithm of minimal angle resolution (LogMAR) was smaller in the perioperative group compared with the postoperative group at 1 week, 1 month, and 3 months after PPV ( < 0.05), but there were no differences thereafter. Compared with the postoperative group, the perioperative group had thinner fovea at 1 week, 1 month, and 3 months ( < 0.05), but the differences disappeared after 3 months. In patients with PCV and vitreous hemorrhage, compared with postoperative anti-VEGF, perioperative anti-VEGF could reduce the difficulty of surgery and reduce the occurrence of postoperative complications, but there were no differences in long-term vision and macular thickness after surgery.
比较玻璃体腔注射抗血管内皮生长因子（VEGF）药物在息肉样脉络膜血管病变（PCV）继发玻璃体积血患者玻璃体切割术（PPV）前后及术后注射的临床效果。这是一项对2013年10月至2019年6月在宁波眼科医院因玻璃体积血接受PPV治疗的患者进行的回顾性研究。纳入因PCV继发玻璃体积血而接受PPV手术的患者。主要结局指标是最佳矫正视力的变化。次要结局指标是中心黄斑厚度。与术后组（n = 20）相比，围手术期组（n = 18）术后抗VEGF注射次数较少（5.1±0.8 vs. 8.0±1.5，P<0.05），早期前房积血发生率较低（5.6% vs. 30.0%；P<0.05），复发性玻璃体积血发生率较低（11.1% vs. 30.0%；P<0.05）。PPV术后1周、1个月和3个月时，围手术期组的最小分辨角对数（LogMAR）低于术后组（P<0.05），但此后无差异。与术后组相比，围手术期组在术后1周、1个月和3个月时黄斑中心凹更薄（P<0.05），但3个月后差异消失。在PCV合并玻璃体积血患者中，与术后抗VEGF治疗相比，围手术期抗VEGF治疗可降低手术难度，减少术后并发症的发生，但术后长期视力和黄斑厚度无差异。
