{"title":"术中使用血管生成抑制剂对增殖性糖尿病视网膜病变手术治疗结果和并发症发生率的影响。","authors":"D V Petrachkov, V M Filippov, S Sh Balkar","doi":"10.17116/oftalma202514102144","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p><p><strong>Purpose: </strong>This study evaluates the effect of intraoperative administration of AIs on the outcomes and complication rates in the surgical treatment of PDR.</p><p><strong>Material and methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>p</i>=0.079 and <i>p</i>=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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":23529,"journal":{"name":"Vestnik oftalmologii","volume":"141 2","pages":"44-50"},"PeriodicalIF":0.0000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[The effects of intraoperative use of angiogenesis inhibitors on outcomes and complication rates in the surgical treatment of proliferative diabetic retinopathy].\",\"authors\":\"D V Petrachkov, V M Filippov, S Sh Balkar\",\"doi\":\"10.17116/oftalma202514102144\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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.</p><p><strong>Purpose: </strong>This study evaluates the effect of intraoperative administration of AIs on the outcomes and complication rates in the surgical treatment of PDR.</p><p><strong>Material and methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>p</i>=0.079 and <i>p</i>=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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":23529,\"journal\":{\"name\":\"Vestnik oftalmologii\",\"volume\":\"141 2\",\"pages\":\"44-50\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Vestnik oftalmologii\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.17116/oftalma202514102144\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Vestnik oftalmologii","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.17116/oftalma202514102144","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
[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.
期刊介绍:
The journal publishes materials on the diagnosis and treatment of eye diseases, hygiene of vision, prevention of ophthalmic affections, history of Russian ophthalmology, organization of ophthalmological aid to the population, as well as the problems of special equipment. Original scientific articles and surveys on urgent problems of theory and practice of Russian and foreign ophthalmology are published. The journal contains book reviews on ophthalmology, information on the activities of ophthalmologists" scientific societies, chronicle of congresses and conferences.The journal is intended for ophthalmologists and scientific workers dealing with clinical problems of diseases of the eye and physiology of vision.