Conbercept Injection in Treatment of Severe Proliferative Diabetic Retinopathy

Ruijin Hospital112 enrolled

Overview

To evaluate efficacy of different intravitreal Conbercept injection therapy in the treatment of severe proliferative diabetic retinopathy.

To assess the clinical effects of preoperative, intraoperative or preoperative combined with intraoperative intravitreal conbercept (IVC) injection in pars plana vitrectomy (PPV) with silicone oil tamponade for severe proliferative diabetic retinopathy (PDR). Methods. These patients were randomly assigned to three groups: Group 1 received an IVC injection 3 to 5 days before surgery; Group 2 received an IVC injection at the end of surgery; and Group 3 received an IVC injection 3 to 5 days before PPV as well as an IVC injection at the end of PPV. Follow-up examinations were performed for at least six months after surgery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

112

Conditions

Proliferative Diabetic Retinopathy Tractional Retinal Detachment

Interventions

ConberceptDRUG

Conbercept is a humanized soluble fusion protein which has a high binding affinity to the Fc region of human immunoglobulin G1 simultaneously. Prior clinical studies have demonstrated that intravitreal conbercept (IVC) inhibits the process of angiogenesis in vivo and in vitro, and has been recognized as a novel effective treatment strategy for neovascularization, providing an alternative treatment option for ophthalmologists.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Subjects of either sex aged ≥ 18 years. 2. Diagnosis of diabetes mellitus (type 1 or type 2); 3. Active proliferative diabetic retinopathy was clinically evident; 4. Study eyes required a vitrectomy and silicone oil tamponade due to vitreous hemorrhage with significant fibrous proliferation, tractional retinal detachment in the posterior pole or complicated retinal detachment, which can be detected by B-scan ultrasonography. 5. Ability to give informed consent. Exclusion Criteria: 1. Coexistent ocular disease that may interfere with visual outcome; 2. Prior vitreoretinal surgery or anti-vascular endothelial growth factor (VEGF) pharmacotherapy in either eye; 3. A macula-involving retinal detachment for \>6 months in the study eye; 4. Iris or angle neovascularization and neovascular glaucoma; 5. known allergy to any components of conbercept formulation 6. severe external ocular infection; 7. pregnancy or current oral contraceptive intake; 8. usage of anticoagulant or antiplatelet therapy; 9. preoperative or postoperative poor diabetes control \[serum hemoglobin A1c (HbA1c) \>11.0%\]; 10. uncontrolled systemic diseases, such as hypertension, cardiac diseases or presenting abnormal coagulation-associated blood diseases; 11. \<6 months of follow-up post initial surgery.

Locations (1)

Ruijin Hospital

Shanghai, Shanghai Municipality, China

Outcomes

Primary Outcomes

Best-corrected Visual Acuity

Time frame: 6 months

Duration of Surgery

To evaluate the influence of these three methods to the final duration of surgery. We carefully estimated the time of the vitrectomy from insertion to extraction of the 23-gauge three-port trocars.

Time frame: during the operation time

Intraoperative Bleeding

The grading criteria for intraoperative bleeding: Grade 1, spontaneous cessation of minor bleeding or bleeding that stopped by transient elevation of perfusion pressure; Grade 2, moderate bleeding requiring endodiathermy or broad blood clots formed far away from the bleeding site; Grade 3, thick blood clots exceeding half of the posterior pole or affecting the operation field.

Time frame: Time between the insertion and extraction of three 23-gauge vitrectomy ports

Secondary Outcomes

Postoperative Preretinal Blood

The grading criteria for postoperative preretinal blood: Grade 1, isolated blood clots within 10 disk area but without covering the posterior pole; Grade 2, broad blood clots exceeding 10 disk area regardless of involvement of the posterior pole; Grade 3, broad blood clots exceeding 10 disk area as well as involving the posterior pole. Maximal extent of preretinal blood within 1 week postoperatively was used for grading the extent of hemorrhage.

Time frame: postoperatively, up to 1 week

Reabsorption Time of Blood

To monitor the reabsorption time of preretinal blood.

Time frame: follow up period, up to an average of 6 months after the operation

Recurrent Vitreous Hemorrhage

Recurrent vitreous hemorrhage(VH) was referred to any new episode of VH occurring after one week postoperatively, dividing into early stage (≤ 4 weeks) and late stage (\> 4 weeks).

Data from ClinicalTrials.gov

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