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早期术后使用贝伐单抗预防增殖性糖尿病视网膜病变玻璃体切割术中新生血管性青光眼

Early postoperative bevacizumab for preventing neovascular glaucoma in phacovitrectomy for proliferative diabetic retinopathy.

作者信息

Hwang Sunjin, Hong Eun Hee, Kang Min Ho, Shin Yong Un

机构信息

Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Gyongchun-ro 153, Guri, Gyeonggi-do, South Korea.

Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, South Korea.

出版信息

Sci Rep. 2025 Jan 7;15(1):1231. doi: 10.1038/s41598-025-85667-y.

Abstract

To evaluate the effectiveness of postoperative intravitreal bevacizumab (IVB) in preventing neovascular glaucoma (NVG) and identify associated risk factors in patients with proliferative diabetic retinopathy (PDR) undergoing phacovitrectomy. Patients with PDR who underwent phacovitrectomy were enrolled and categorized into two subgroups based on their postoperative treatment regimen: one group received IVB within 2 months following phacovitrectomy (Group 1); the other did not receive IVB during this period (Group 2). A comparative analysis evaluated the distinguishing characteristics of the two groups after 1:1 propensity score matching. Kaplan-Meier survival analysis was utilized to determine the incidence of NVG after phacovitrectomy. Multivariate analysis with the Cox proportional hazards model identified risk factors associated with NVG postphacovitrectomy. A total of 206 eyes of 206 patients were investigated in this study. NVG developed in 15 eyes (7.28%). The probabilities of NVG occurrence at 6, and 12 months following phacovitrectomy were 4.85%, and 7.28%, respectively. When comparing Groups 1 (n = 57) and 2 (n = 57), a significant difference was observed in the occurrence of NVG (P < 0.001). In Group 1, only one case of NVG (1.75%) were noted, whereas all other NVG cases occurred in Group 2 (9.39%). Male sex and high preoperative intraocular pressure (IOP) were associated with NVG occurrence following phacovitrectomy, and the administration of IVB within 2 months postphacovitrectomy demonstrated efficacy in preventing the development of NVG. Male sex and high preoperative IOP were associated with a higher incidence of NVG, and postoperative IVB had a protective effect against NVG occurrence.

摘要

评估玻璃体腔注射贝伐单抗(IVB)预防新生血管性青光眼(NVG)的有效性,并确定接受晶状体玻璃体切除术的增殖性糖尿病视网膜病变(PDR)患者的相关危险因素。将接受晶状体玻璃体切除术的PDR患者纳入研究,并根据其术后治疗方案分为两个亚组:一组在晶状体玻璃体切除术后2个月内接受IVB治疗(第1组);另一组在此期间未接受IVB治疗(第2组)。经过1:1倾向评分匹配后,进行比较分析以评估两组的特征差异。采用Kaplan-Meier生存分析确定晶状体玻璃体切除术后NVG的发生率。使用Cox比例风险模型进行多变量分析,以确定与晶状体玻璃体切除术后NVG相关的危险因素。本研究共调查了206例患者的206只眼。15只眼(7.28%)发生了NVG。晶状体玻璃体切除术后6个月和12个月时NVG发生的概率分别为4.85%和7.28%。比较第1组(n = 57)和第2组(n = 57)时,NVG的发生率存在显著差异(P < 0.001)。在第1组中,仅观察到1例NVG(1.75%),而所有其他NVG病例均发生在第2组(9.39%)。男性和术前高眼压与晶状体玻璃体切除术后NVG的发生相关,晶状体玻璃体切除术后2个月内给予IVB显示出预防NVG发生的效果。男性和术前高眼压与NVG的较高发生率相关,术后IVB对NVG的发生具有保护作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/efa4/11707291/85cc6ae0fef1/41598_2025_85667_Fig1_HTML.jpg

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