Arevalo J Fernando, Beatson Bradley
Wilmer Eye Institute, Johns Hopkins School of Medicine, 600 N Wolfe St; Maumenee 713, Baltimore, MD, 21287, USA.
Int J Retina Vitreous. 2023 Apr 18;9(1):29. doi: 10.1186/s40942-023-00467-8.
The treatment of proliferative diabetic retinopathy (PDR) has evolved significantly since the initial use of panretinal photocoagulation as a treatment in the 1950s. Vascular endothelial growth factor inhibitors have provided an effective alternative without the risk of peripheral vision loss. Despite this, the risk of complications requiring surgical intervention in PDR remains high. Intravitreal bevacizumab has shown promise as a preoperative adjuvant to vitrectomy for PDR complications, albeit with a purported risk for tractional retinal detachment (TRD) progression in eyes with significant fibrous proliferation. Here we will discuss anti-VEGF agent use in PDR and its role in surgical intervention for PDR complications including TRD.
自20世纪50年代首次将全视网膜光凝作为增殖性糖尿病视网膜病变(PDR)的治疗方法以来,PDR的治疗方法有了显著发展。血管内皮生长因子抑制剂提供了一种有效的替代方法,且没有周边视力丧失的风险。尽管如此,PDR中需要手术干预的并发症风险仍然很高。玻璃体内注射贝伐单抗已显示出有望作为PDR并发症玻璃体切除术的术前辅助治疗,尽管对于有明显纤维增殖的眼睛存在牵引性视网膜脱离(TRD)进展的风险。在此,我们将讨论抗VEGF药物在PDR中的应用及其在PDR并发症(包括TRD)手术干预中的作用。