Proliferative diabetic retinopathy (PDR) is the most common causes of irreversible blindness in diabetic retinopathy (DR).Although pars plana vitrectomy (PPV) is the cornerstone for treatment of advanced PDR, related postoperative complications such as recurrent VH, NVG, and postoperative fibrovascular proliferation progression may still cause serious visual impairment. Preoperative intravitreal injections of anti-VEGF drugs may represent a new strategy for making vitrectomy safer and more effective for severe PDR.
Proliferative diabetic retinopathy (PDR) is the most common causes of irreversible blindness in diabetic retinopathy (DR).It is characterized by progressive loss of vision, retinal edema, vitreous hemorrhage (VH), retinal neovascularization, fibrovascular proliferation, tractional retinal detachment (TRD) and neovascular glaucoma (NVG).Although pars plana vitrectomy (PPV) is the cornerstone for treatment of advanced PDR, related postoperative complications such as recurrent VH, NVG, and postoperative fibrovascular proliferation progression may still cause serious visual impairment. It is well known that vascular endothelial growth factor (VEGF) is a leading role of the neovascularization, vascular permeability, and diabetic macular edema.preoperative intravitreal injections of anti-VEGF drugs may represent a new strategy for making vitrectomy safer and more effective for severe PDR.Until now, there are two kinds of anti-VEGF drugs in China, including monoclonal antibodies, like imported drug Ranibizumab, militating by block VEGF-A, and fusion proteins, like domectic drug Conbercept, competitively inhibiting the binding of VEGF with its receptor by blocking multiple targets, VEGF-A, VEGF-B, and placental insulin-like growth factor (PlGF). Studies focusing on the comparison of efficacy between preoperative intravitreal injections of the two drugs for patients with severe PDR undergoing vitrectomy is still limited. Thus, in this study, we aim to carry out a more comprehensive comparison in intraoperative and postoperative aspects on the efficacy and safety between intravitreal ranibizumab injection (IVR) and intravitreal conbercept injection (IVC) before vitrectomy of PDR.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
IVR group means patients received intravitreal ranibizumab injections (IVR) (0.5mg/0.05ml) before vitreous surgery. IVC group means patients that received intravitreal conbercept injection (IVC) (0.5mg/0.05ml) before vitreous surgery.
Peking University People's Hospital
Beijing, Beijing Municipality, China
BCVA
best-corrected visual acuity
Time frame: from preoperation to 3 months follow-up
CRT
central retinal thickness
Time frame: from preoperation to 3 months follow-up
surgery time
surgery time
Time frame: during surgery
intraoperative bleeding
intraoperative bleeding
Time frame: during surgery
intraocular electrocoagulation use
intraocular electrocoagulation use
Time frame: during surgery
incidence of iatrogenic retinal breaks
incidence of iatrogenic retinal breaks
Time frame: during surgery
relaxing retinotomy
relaxing retinotomy
Time frame: during surgery
retinal reattachment
retinal reattachment
Time frame: during surgery
silicone oil tamponade
silicone oil tamponade
Time frame: during surgery
postoperative vitreous hemorrhage (VH)
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Masking
QUADRUPLE
Enrollment
80
postoperative vitreous hemorrhage (VH)
Time frame: during 3 months follow-up
neovascular glaucoma (NVG)
neovascular glaucoma (NVG)
Time frame: during 3 months follow-up
recurrent retinal detachment
recurrent retinal detachment
Time frame: during 3 months follow-up
postoperative fibrovascular proliferation progression
postoperative fibrovascular proliferation progression
Time frame: during 3 months follow-up