National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.
The Third Affiliated Hospital of Wenzhou Medical University, Ruian, Zhejiang Province, 325200, China.
BMC Ophthalmol. 2024 Sep 6;24(1):398. doi: 10.1186/s12886-024-03634-z.
To investigate the effectiveness of anti-vascular endothelial growth factor (VEGF) therapy on post-vitrectomy macular edema (PVME) and determine the risk factors for PVME recovery.
This retrospective study included 179 eyes of 179 patients who underwent pars plana vitrectomy for proliferative diabetic retinopathy and developed PVME within 3 months after surgery. Eyes were grouped according to postoperative anti-VEGF treatment.
Central retinal thickness (CRT) decreased significantly from baseline to 3-month follow-up in groups with (509.9 ± 157.2 μm vs. 401.2 ± 172.1 μm, P < 0.001) or without (406.1 ± 96.1 μm vs. 355.1 ± 126.0 μm, P = 0.008) postoperative anti-VEGF treatment. Best-corrected visual acuity (BCVA) did not differ between the two groups during follow-up. In the group not receiving anti-VEGF therapy, BCVA was significantly improved at 1, 2, and 3 months (P = 0.007, P < 0.001, and P < 0.001, respectively), while in the anti-VEGF group, BCVA was significantly improved at 1 and 3 months (P = 0.03 and P < 0.001). A thicker baseline CRT (β = 0.44; 95% confidence interval, 0.26-0.61; P < 0.001) was significantly associated with decreasing CRT.
PVME tends to spontaneously resolve in the early postoperative period. The effect of anti-VEGF therapy in the first 3 months after diagnosis appears to be limited.
研究抗血管内皮生长因子（VEGF）治疗对玻璃体切除术后黄斑水肿（PVME）的疗效，并确定 PVME 恢复的相关风险因素。
本回顾性研究纳入了 179 例（179 只眼）接受玻璃体切除术治疗增生性糖尿病视网膜病变的患者，这些患者术后 3 个月内发生了 PVME。根据术后是否接受抗 VEGF 治疗将眼分为两组。
接受（509.9±157.2μm 比 401.2±172.1μm，P<0.001）或未接受（406.1±96.1μm 比 355.1±126.0μm，P=0.008）术后抗 VEGF 治疗的两组，视网膜中央厚度（CRT）自基线至 3 个月随访时均显著降低。两组在随访期间最佳矫正视力（BCVA）无差异。未接受抗 VEGF 治疗的组中，BCVA 在 1、2 和 3 个月时显著改善（P=0.007、P<0.001 和 P<0.001），而在抗 VEGF 组中，BCVA 在 1 和 3 个月时显著改善（P=0.03 和 P<0.001）。基线 CRT 较厚（β=0.44；95%置信区间，0.26-0.61；P<0.001）与 CRT 降低显著相关。
PVME 在术后早期有自发消退趋势。在诊断后前 3 个月，抗 VEGF 治疗的效果似乎有限。
