Ranibizumab Pretreatment in Vitrectomy with Internal Limiting Membrane Peeling on Diabetic Macular Edema in Severe Proliferative Diabetic Retinopathy
Open Access
- 30 April 2020
- journal article
- research article
- Published by Springer Nature in Diabetes Therapy
- Vol. 11 (6), 1397-1406
- https://doi.org/10.1007/s13300-020-00822-0
Abstract
Aim To evaluate the efficacy of intravitreal ranibizumab (IVR) pretreatment for pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling in severe proliferative diabetic retinopathy (PDR) combined with macular edema (ME). Methods Sixty-three patients with ME and PDR were divided into IVR and control groups. Three days before PPV stripping, ranibizumab was injected into the patients in the IVR group. The patients were followed for 6 months. The best-corrected visual acuity (BCVA), visual acuity improvement, centre macular thickness (CMT), and intraoperative and postoperative complications were compared between the two groups. Results The BCVA of the IVR group was significantly improved at 1, 3 and 6 months compared with the preoperative BCVA (P < 0.01). The BCVA of the control group was significantly improved at 3 and 6 months compared with the preoperative BCVA (P < 0.01), but was not significantly improved at 1 month. At 1 and 3 months, the BCVA of the IVR group was significantly better than that of the control group after surgery, with no difference between the two groups at 6 months. The CMT of the IVR group was thinner than that of the control group at 1 and 3 months (P < 0.01), with no significant difference at 6 months after surgery. The surgical time, the risk of intraoperative bleeding, the incidence of iatrogenic retinal breaks, the frequency of endodiathermy and the rate of silicone oil tamponade were significantly different between the two groups (all P < 0.05). There was no significant difference between the two groups in terms of postoperative complications. Conclusions Ranibizumab pretreatment may improve the outcome of PPV with ILM peeling for severe PDR with ME by decreasing ME and intraoperative complications.Keywords
This publication has 27 references indexed in Scilit:
- Pharmacokinetics of Ranibizumab in Patients with Neovascular Age-Related Macular Degeneration: A Population ApproachInvestigative Opthalmology & Visual Science, 2013
- Intravitreal Ranibizumab for Diabetic Macular Edema with Prompt versus Deferred Laser TreatmentOphthalmology, 2012
- The Effect of Adjunctive Intravitreal Bevacizumab for Preventing Postvitrectomy Hemorrhage in Proliferative Diabetic RetinopathyOphthalmology, 2011
- A systematic review and meta-analysis of clinical outcomes of vitrectomy with or without intravitreal bevacizumab pretreatment for severe diabetic retinopathyBritish Journal of Ophthalmology, 2011
- A review of clinical trials of anti-VEGF agents for diabetic retinopathyAlbrecht von Graefes Archiv für Ophthalmologie, 2010
- Pars Plana Vitrectomy with Internal Limiting Membrane Peeling Compared with Intravitreal Triamcinolone Injection in the Treatment of Diabetic Macular EdemaOphthalmologica, 2008
- A Phase II Randomized Clinical Trial of Intravitreal Bevacizumab for Diabetic Macular EdemaOphthalmology, 2007
- Vitrectomy for Diabetic Macular Edema with and without Internal Limiting Membrane RemovalOphthalmologica, 2005
- Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scalesOphthalmology, 2003
- Modified Grid Laser Photocoagulation for Diffuse Diabetic Macular EdemaOphthalmology, 1991