Abstract:AIM:To retrospectively analyze clinical effect of laser therapy combined with or without Ranibizumab for patients with proliferative diabetic retinopathy(PDR).
METHODS:From August 2009 to February 2015, the data of 33 PDR patients(66 eyes)with only neovascular vessels(including the nipple or retina)without proliferative fiber membrane from retinal or vitreous hemorrhage was recorded and followed-up. Treatment 1: the pan-retinal laser photocoagulation by several times in 1mo were completed; treatment 2: patients were given intravitreal injection of ranibizumab at first, 5d later laser photocoagulation by several times, and the pan-retinal laser photocoagulation was completed in 1mo. All patients before and after laser treatment 1, 2, 3wk, 1, 2 and 3mo were followed-up on visual acuity(VA), intraocular pressure(IOP), fundus examination, type B ultrasound etc.
RESULTS:In the 33 patients with PDR, there were 16 males(32 eyes), 17 females(34 eyes), and aged 23~65 years old. The 18 patients(36 eyes)treated with treatment 1,had 10 eyes(28%)with VA<0.3, 20 eyes(56%)with VA 0.3~0.6, 6 eyes(17%)with VA 0.8~1.0; vitreous hemorrhage happened in 22 eyes(61%)during the treatments; macular edema happened or became worse in 10 eyes(28%). The 15 patients(30 eyes)treated with treatment 2,had 9 eyes(30%)with VA<0.3, 15 eyes(50%)with VA 0.3~0.6, 6 eyes(20%)with VA 0.8~1.0; vitreous hemorrhage happened in 6 eyes(20%)during the treatments; macular edema happened or became worse in 4 eyes(13%). The VA and other aspects between the two groups before treatments had no significant differences(P<0.05).After the two kinds of treatments, the difference on VA between the two groups was statistically significant(P>0.05).
CONCLUSION:Intravitreal injection of ranibizumab before laser photocoagulation can reduce the risk of complications, such as vitreous hemorrhage and macular edema. This treatment is an effective way for PDR patients with only neovascular vessels and without proliferative fiber membrane from retinal or vitreous hemorrhage, which can reduce the risk of complications, such as vitreous hemorrhage and macular edema, reduce the injury for patients' VA and improve the compliance in patients.