Alhaj Shaikha S, AlQattan Noora, Ismail Fatma A, Alshaikh Fatma, Al Hasid Hassan
Graduate Medical Education, Dubai Health, Dubai, ARE.
Ophthalmology, Sheikh Khalifa Medical City, Abu Dhabi, ARE.
Cureus. 2025 Aug 11;17(8):e89778. doi: 10.7759/cureus.89778. eCollection 2025 Aug.
Proliferative diabetic retinopathy (PDR) affects approximately 1.5% of adults with diabetes and is a leading cause of blindness due to complications such as vitreous hemorrhage. Pan-retinal photocoagulation (PRP) has been the mainstay of treatment for many years. Still, the advent of anti-vascular endothelial growth factor (anti-VEGF) agents, including ranibizumab, bevacizumab, and aflibercept, presents successful therapeutic options. This study aims to conduct a systematic review and meta-analysis to compare the efficacy of anti-VEGF therapy combined with vitrectomy versus vitrectomy alone in patients with vitreous hemorrhage due to diabetic retinopathy. Many electronic sources, such as PubMed and Google Scholar, were searched for pertinent literature. PICOS (population, intervention, comparison, outcomes, and study) criteria were applied to select the studies systematically. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) framework was employed to synthesize and report data. The analysis included six studies with a total of 468 patients. Results indicated a significant improvement in best-corrected visual acuity (BCVA) at three months in the anti-VEGF group compared to vitrectomy alone (MD = -0.19; p = 0.02), while no significant differences were found at one month (MD = 0.08; p = 0.50) and six months (MD = 0.03; p = 0.40). Additionally, no significant differences in recurrent vitreous hemorrhage rates were observed between groups. In conclusion, anti-VEGF drugs combined with vitrectomy showed significant improvements in BCVA at three months as compared to vitrectomy alone, indicating their potential effectiveness for diabetic vitreous hemorrhages. However, the scarcity of available research emphasizes the necessity of carrying out extensive clinical trials to validate the safety and efficacy of anti-VEGF treatment as compared to alternative treatment options.
增殖性糖尿病视网膜病变（PDR）影响约1.5%的成年糖尿病患者，是导致失明的主要原因，如玻璃体出血等并发症。全视网膜光凝（PRP）多年来一直是主要的治疗方法。然而，包括雷珠单抗、贝伐单抗和阿柏西普在内的抗血管内皮生长因子（抗VEGF）药物的出现，提供了成功的治疗选择。本研究旨在进行系统评价和荟萃分析，比较抗VEGF治疗联合玻璃体切除术与单纯玻璃体切除术治疗糖尿病视网膜病变所致玻璃体出血患者的疗效。通过搜索许多电子资源，如PubMed和谷歌学术，查找相关文献。应用PICOS（人群、干预措施、对照、结局和研究）标准系统地选择研究。采用系统评价和荟萃分析的首选报告项目（PRISMA）框架来综合和报告数据。该分析纳入了6项研究，共468例患者。结果表明，与单纯玻璃体切除术相比，抗VEGF组在3个月时最佳矫正视力（BCVA）有显著改善（MD = -0.19；p = 0.02），而在1个月（MD = 0.08；p = 0.50）和6个月（MD = 0.03；p = 0.40）时未发现显著差异。此外，两组间复发性玻璃体出血率无显著差异。总之，与单纯玻璃体切除术相比，抗VEGF药物联合玻璃体切除术在3个月时BCVA有显著改善，表明其对糖尿病性玻璃体出血有潜在疗效。然而，现有研究的匮乏强调了开展广泛临床试验以验证抗VEGF治疗与其他治疗选择相比的安全性和有效性的必要性。
