The effect of intravitreal injection of ranibizumab and pan-retina photocoagulation in the treatment of severe proliferative diabetic retinopathy wih 23G vitreoretinal surgery_Chinese Journal of Ocular Fundus Diseases

Authors：

FuYudong , WangPing , JiangLi , 白海青 , 王大博 ,  孟旭霞

Department of Ophthalmology, The Affiliated Hospital of Qingdao University, Huangdao Campus, Qingdao 266555, China;

Corresponding author：

孟旭霞, Email: mengxuxia@163.com

Keywords：

Diabetic retinopathy/therapy; Angiogenesis inhibitors/therapeutic use; Antibodies, monoclonal/therapeutic use; Laser coagulation; Vitrectomy

DOI：

10.3760/cma.j.issn.1005-1015.2015.02.008

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Objective To observe the different effect of 23G vitrectomy surgery assisted with intravitreal injection of ranibizumab and pan-retina photocoagulation in severe proliferative diabetic retinopathy (PDR) treatment. Methods A total of 60 patients (78 eyes) with severe PDR diagnosed were enrolled and divided into intravitreal injection of Lucentis group (Group A, 22 patients, 28 eyes), pan-retina photocoagulation group (Group B, 18 patients, 20 eyes) and control group (Group C, 20 patients, 30 eyes), all of them received 23G vitreoretinal surgery. The average operation time, iatrogenic hiatus, the use of filler and electric coagulation, postoperative bleeding and best corrected visual acuity in three months were comparatively analyzed among the three groups. Results The operation time in the three group was (67.429±11.243), (77.762±10.435), (106.839±20.724) min respectively, the differences of A vs C and B vs C were statistically significant(t=8.940, 5.928; P < 0.05). Five eyes needed electric coagulation in Group A, 6 eyes in Group B, and 24 eyes in Group C, the differences of A vs C and B vs C were all statistically significant (χ²=19.955, 10.505;P < 0.05). Four eyes used the filler in Group A, 3 eyes in Group B, and 23 eyes in Group C, the differences of A vs C and B vs C were all statistically significant (χ²=18.099, 14.083;P < 0.05). The difference of iatrogenic hiatus and postoperative bleeding was no significance among the three groups (P > 0.05). The best corrected visual acuity of 3 months after surgery in the three group is (0.383±0.122), (0.251±0.067), (0.104±0.044) respectively, the differences of A vs C and B vs C were all statistically significant(t=11.909, 13.616;P < 0.05). Conclusion The intravitreaI injection of ranibizumab or pan-retina photocoagulation treatment before the vitrectomy surgery is very effective, both of them can shorten the operation time, reduce electric coagulation and use of filler, and improve patients' eyesight.

Citation： FuYudong, WangPing, JiangLi. The effect of intravitreal injection of ranibizumab and pan-retina photocoagulation in the treatment of severe proliferative diabetic retinopathy wih 23G vitreoretinal surgery. Chinese Journal of Ocular Fundus Diseases, 2015, 31(2): 143-146. doi: 10.3760/cma.j.issn.1005-1015.2015.02.008 Copy

1.	Cunha-Vaz J. Lowering the risk of visual impainment and bilndbess[J]. Diabet Med, 1998, 15(Suppl 4):S47-50.
2.	Fong DS, Ferris FL 3rd, Davis MD, et al. Causes of severe visual loss in the early treatment diabetic retinopathy study:ETDRS report no. 24. Early Treatment Diabetic Retinopathy Study Research Group[J]. Am J Ophthalmol, 1999, 127(2):137-141.
3.	齐慧君, 黎晓新.不同分期糖尿病视网膜病变激光治疗预后分析[J].中国实用眼科杂志, 2004, 22(10):801-803.
4.	沈玺, 徐建敏, 李娜, 等.23G和20G玻璃体手术治疗增生型糖尿病视网膜病变的对比观察[J].中华眼底病杂志, 2012, 28(3):232-236.
5.	中华医学会眼科学会眼底病学组.我国糖尿病视网膜病变临床诊疗指南(2014年)[J].中华眼科杂志, 2014, 50(11):851-865.
6.	Centers for Disease Control and Prevention. Prevalence and incidence of diabetes mellitus in United States, 1980-1987[J]. MMWR Morb Mortal Wkly Rep, 1990, 39(45):809-812.
7.	Valiatti FB, Crispim D, Benfica C, et al. The role of vascular endothelial growth factor in angiogenesis and diabetic retinopathy[J].Arq Bras Endocrinol Metabol, 2011, 55(2):106-113.
8.	Mason JO, Nixon PA, White MF. Intravitreal injection of bevacizumab (Avastin) as adjunctive treatment of proliferative diabetic retinopathy[J].Am J Ophthalmol, 2006, 142(4):685-688.
9.	Ambati J, Chalam KV, Chawla DK, et al. Elevated gamma-aminobutyric acid, glutamate and vascular endothelial growth factor levels in the vitreous of proliferative diabetic retinopathy[J]. Arch Ophthalmol, 1997, 15(9):1161-1166.
10.	di Lauro R, De Ruggiero P, di Lauro R, et al. Intravitreal bevacizumab for surgical treatment of severe proliferative diabetic retinopathy[J]. Graefe's Arch Clin Exp Ophthalmol, 2010, 248 (6):785-791.
11.	El-Sabagh HA, Abdelghaffar W, Labib AM, et al. Preoperative intravitreal bevacizumab use as an adjuvant to diabetic vitrectomy:histopathologic findings and clinical implications[J]. Ophthalmology, 2011, 118(4):636-641.
12.	Figueroa MS, Contreras I, Noval S. Anti angiogenic drugs as an adjunctive therapy in the surgical treatment of diabetic retinopathy[J].Curr Diabetes Rev, 2009, 5(1):52-56.
13.	李晖. YAG激光全视网膜光凝治疗早期糖尿病视网膜眼底病变[J].中国激光医学杂志, 2008, 17(4):261-263.
14.	周正申, 王玲, 王康孙, 等.激光对水肿视网膜的生物效应[J].中国实用眼科杂志, 2003, 21(8):572.
15.	李涛, 郑志, 郑冰清, 等.贝伐单抗辅助的23G玻璃体切割术治疗严重增生性糖尿病视网膜病变的疗效观察[J].现代生物学进展, 2013, 13(23):4488-4491.
16.	马凯, 张风. 23G玻璃体手术系统治疗增生性糖尿病视网膜病变的回顾分析[J].眼科, 2012, 21(2):97-101.
17.	Ahmadieh H, Shoeibi N, Entezari M, et al. Intravitreal bevaeizumab for prevention of early postvitrectomy hemorrhage in diabetic patients:a randomized elinical trial[J].Ophthalmology, 2009, 116(10):1943-1948.
18.	Mete A, Saygili O, Gungor K, et al.Does ranibizumab (Lucentis) change retrobulbar blood flow in patients with neovascular age-relatedmacular degeneration?[J]. Ophthalmic Res, 2012, 47(3):141-145.

1. Cunha-Vaz J. Lowering the risk of visual impainment and bilndbess[J]. Diabet Med, 1998, 15(Suppl 4):S47-50.
2. Fong DS, Ferris FL 3rd, Davis MD, et al. Causes of severe visual loss in the early treatment diabetic retinopathy study:ETDRS report no. 24. Early Treatment Diabetic Retinopathy Study Research Group[J]. Am J Ophthalmol, 1999, 127(2):137-141.
3. 齐慧君, 黎晓新.不同分期糖尿病视网膜病变激光治疗预后分析[J].中国实用眼科杂志, 2004, 22(10):801-803.
4. 沈玺, 徐建敏, 李娜, 等.23G和20G玻璃体手术治疗增生型糖尿病视网膜病变的对比观察[J].中华眼底病杂志, 2012, 28(3):232-236.
5. 中华医学会眼科学会眼底病学组.我国糖尿病视网膜病变临床诊疗指南(2014年)[J].中华眼科杂志, 2014, 50(11):851-865.
6. Centers for Disease Control and Prevention. Prevalence and incidence of diabetes mellitus in United States, 1980-1987[J]. MMWR Morb Mortal Wkly Rep, 1990, 39(45):809-812.
7. Valiatti FB, Crispim D, Benfica C, et al. The role of vascular endothelial growth factor in angiogenesis and diabetic retinopathy[J].Arq Bras Endocrinol Metabol, 2011, 55(2):106-113.
8. Mason JO, Nixon PA, White MF. Intravitreal injection of bevacizumab (Avastin) as adjunctive treatment of proliferative diabetic retinopathy[J].Am J Ophthalmol, 2006, 142(4):685-688.
9. Ambati J, Chalam KV, Chawla DK, et al. Elevated gamma-aminobutyric acid, glutamate and vascular endothelial growth factor levels in the vitreous of proliferative diabetic retinopathy[J]. Arch Ophthalmol, 1997, 15(9):1161-1166.
10. di Lauro R, De Ruggiero P, di Lauro R, et al. Intravitreal bevacizumab for surgical treatment of severe proliferative diabetic retinopathy[J]. Graefe's Arch Clin Exp Ophthalmol, 2010, 248 (6):785-791.
11. El-Sabagh HA, Abdelghaffar W, Labib AM, et al. Preoperative intravitreal bevacizumab use as an adjuvant to diabetic vitrectomy:histopathologic findings and clinical implications[J]. Ophthalmology, 2011, 118(4):636-641.
12. Figueroa MS, Contreras I, Noval S. Anti angiogenic drugs as an adjunctive therapy in the surgical treatment of diabetic retinopathy[J].Curr Diabetes Rev, 2009, 5(1):52-56.
13. 李晖. YAG激光全视网膜光凝治疗早期糖尿病视网膜眼底病变[J].中国激光医学杂志, 2008, 17(4):261-263.
14. 周正申, 王玲, 王康孙, 等.激光对水肿视网膜的生物效应[J].中国实用眼科杂志, 2003, 21(8):572.
15. 李涛, 郑志, 郑冰清, 等.贝伐单抗辅助的23G玻璃体切割术治疗严重增生性糖尿病视网膜病变的疗效观察[J].现代生物学进展, 2013, 13(23):4488-4491.
16. 马凯, 张风. 23G玻璃体手术系统治疗增生性糖尿病视网膜病变的回顾分析[J].眼科, 2012, 21(2):97-101.
17. Ahmadieh H, Shoeibi N, Entezari M, et al. Intravitreal bevaeizumab for prevention of early postvitrectomy hemorrhage in diabetic patients:a randomized elinical trial[J].Ophthalmology, 2009, 116(10):1943-1948.
18. Mete A, Saygili O, Gungor K, et al.Does ranibizumab (Lucentis) change retrobulbar blood flow in patients with neovascular age-relatedmacular degeneration?[J]. Ophthalmic Res, 2012, 47(3):141-145.

Chinese Journal of Ocular Fundus Diseases

The effect of intravitreal injection of ranibizumab and pan-retina photocoagulation in the treatment of severe proliferative diabetic retinopathy wih 23G vitreoretinal surgery

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