Результаты лечения пациентов с пролиферативной диабетической ретинопатией методом витректомии, проведенной после инъекции Ранимизумаба (Луцентиса)

Abstract

Purpose. To evaluate the results of the combined treatment with intravitreal ranibizumab injection (IVR) followed by pars plana vitrectomy (PPV) in patients with proliferative diabetic retinopathy (PDR). Material and methods. The study involved 69 patients with PDR had IVR followed by 23G PPV. The patients were divided into 3 subgroups: subgroup 1 – PPV 1 day after IVR, subgroup 2 – PPV 3 days after IVR, and subgroup 3 – PPV 5 or 7 days after IVR. The control group consisted of 23 patients operated on before the study started or patients who did not agree for anti-VEGF injection before vitrectomy. Results. The regression of the pathological vessels was observed in all the subgroups with IVR injection pretreatment. Six-months postvitrectomy a BCVA improvement was observed in the IVR groups in 87% of the patients and in 70% of the patients in the control group (p<0.203). Among the patients without renal failure the IVR groups had 4 times higher chances for the BCVA improvement than in the control group (p<0.133). After excluding the influence of the diabetes duration the odds became statistically significant (p<0.050) – over 10 times higher. Retinal detachment (RD) at the primary examination reduced the chance for BCVA improvement at 3 (p<0.020) and 6 (p<0.068) months postvitrectomy. Conclusions. IVR in patients with PDR cause pathological neovascularization regression, reduces intraoperative bleeding and increases the chances for BCVA improvement, especially in the groups with proper renal function and without any cardiovascular complications.