[The effects of intraoperative use of angiogenesis inhibitors on outcomes and complication rates in the surgical treatment of proliferative diabetic retinopathy].

Treatment of proliferative diabetic retinopathy (PDR) complications, such as vitreous haemorrhage and tractional retinal detachment, as well as macular involvement, remains a complex multifactorial challenge. The use of angiogenesis inhibitors (AIs) at different stages of patient management is being investigated. In particular, intraoperative use of AIs appears to be pathogenetically justified.

Purpose: This study evaluates the effect of intraoperative administration of AIs on the outcomes and complication rates in the surgical treatment of PDR.

Material and methods: A comparative analysis of anatomical and functional outcomes, as well as postoperative complication rates, was performed in two comparable groups of patients who underwent surgery for PDR complications: one with intraoperative AI use (60 cases, 60 eyes), and one without it (109 cases, 109 eyes). The evaluation was conducted at the early (1 month) and long-term (6 months) postoperative follow-ups.

Results: The use of AIs was significantly correlated with higher postoperative visual acuity at all follow-up periods and with lower central retinal thickness (CRT) at 1 month after surgery. The complication rate was numerically higher in the group without AIs use, with borderline statistical significance noted for vitreous hemorrhage and anterior segment neovascularization (p=0.079 and p=0.096, respectively). No statistically significant differences were observed between the groups in the incidence of diabetic macular edema (DME) or cases of vitreous hemorrhage requiring revision surgery.

Conclusion: Given the high variability in clinical presentation of PDR, the use of AIs at different stages of treatment is justified. The study provides promising insights into the effects of intraoperative AIs administration on anatomical and functional outcomes, as well as complication rates. Further research into AIs effects taking into account the cytokine profile may be relevant for the personalized selection of treatment strategies.