Sun Xincheng, Wang Xianhuai, Guo Xinyu, Wang Mengjiao, Liu Hu
Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China.
Department of Ophthalmology, The Affiliated Changzhou No 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, China.
Ophthalmol Ther. 2023 Dec;12(6):3133-3142. doi: 10.1007/s40123-023-00803-z. Epub 2023 Sep 15.
This study aimed to evaluate the combined administration of anti-vascular endothelial growth factor (anti-VEGF) drugs before and during pars plana vitrectomy (PPV) and to explore its efficacy and safety in the treatment of patients with severe proliferative diabetic retinopathy (PDR).
This retrospective case series included consecutive patients who underwent PPV. Patients were categorized into two groups: the preoperative group was injected with anti-VEGF drugs before PPV, and the combination group was injected with anti-VEGF drugs before and during PPV. Preoperative, intraoperative, and postoperative clinical data were collected for analysis. The main outcome measures were changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) and occurrence of postoperative vitreous cavity haemorrhage (POVCH).
In total, 63 eyes of 60 patients with severe PDR were analysed. The operative duration and occurrence of intraoperative haemorrhage, iatrogenic retinal breaks, and silicone oil tamponade were similar between the two groups. The benefits on BCVA, and CRT after 1 week postoperatively, were more obvious in the combination group (P < 0.01). Combination therapy had the potential to reduce the incidence of POVCH. No ocular or systemic adverse events occurred in either group.
The combined use of anti-VEGF drugs before and during PPV in patients with severe PDR not only includes the advantages of preoperative injection, but also has more significant prognostic benefits and favourable safety profiles.
本研究旨在评估在玻璃体切割术（PPV）前及术中联合应用抗血管内皮生长因子（anti-VEGF）药物，并探讨其在治疗重度增殖性糖尿病视网膜病变（PDR）患者中的疗效和安全性。
本回顾性病例系列研究纳入了连续接受PPV的患者。患者分为两组：术前组在PPV前注射抗VEGF药物，联合组在PPV前及术中均注射抗VEGF药物。收集术前、术中和术后的临床资料进行分析。主要观察指标为最佳矫正视力（BCVA）、视网膜中央厚度（CRT）的变化以及术后玻璃体腔出血（POVCH）的发生情况。
共分析了60例重度PDR患者的63只眼。两组的手术时间、术中出血、医源性视网膜裂孔及硅油填充的发生率相似。联合组术后1周时在BCVA和CRT方面的改善更明显（P < 0.01）。联合治疗有可能降低POVCH的发生率。两组均未发生眼部或全身不良事件。
在重度PDR患者中，PPV前及术中联合使用抗VEGF药物不仅具有术前注射的优势，还具有更显著的预后益处和良好的安全性。
