Effect of anti-vascular endothelial growth factor on early-stage post-vitrectomy macular edema in patients with proliferative diabetic retinopathy

BMC Ophthalmol. 2024 Sep 6;24(1):398. doi: 10.1186/s12886-024-03634-z.

Abstract

Purpose: To investigate the effectiveness of anti-vascular endothelial growth factor (VEGF) therapy on post-vitrectomy macular edema (PVME) and determine the risk factors for PVME recovery.

Methods: This retrospective study included 179 eyes of 179 patients who underwent pars plana vitrectomy for proliferative diabetic retinopathy and developed PVME within 3 months after surgery. Eyes were grouped according to postoperative anti-VEGF treatment.

Results: Central retinal thickness (CRT) decreased significantly from baseline to 3-month follow-up in groups with (509.9 ± 157.2 μm vs. 401.2 ± 172.1 μm, P < 0.001) or without (406.1 ± 96.1 μm vs. 355.1 ± 126.0 μm, P = 0.008) postoperative anti-VEGF treatment. Best-corrected visual acuity (BCVA) did not differ between the two groups during follow-up. In the group not receiving anti-VEGF therapy, BCVA was significantly improved at 1, 2, and 3 months (P = 0.007, P < 0.001, and P < 0.001, respectively), while in the anti-VEGF group, BCVA was significantly improved at 1 and 3 months (P = 0.03 and P < 0.001). A thicker baseline CRT (β = 0.44; 95% confidence interval, 0.26-0.61; P < 0.001) was significantly associated with decreasing CRT.

Conclusion: PVME tends to spontaneously resolve in the early postoperative period. The effect of anti-VEGF therapy in the first 3 months after diagnosis appears to be limited.

Keywords: Anti–vascular endothelial growth factor; Diabetic macular edema; Postoperative; Proliferative diabetic retinopathy; Vitrectomy.

MeSH terms

  • Aged
  • Angiogenesis Inhibitors* / therapeutic use
  • Bevacizumab / administration & dosage
  • Bevacizumab / therapeutic use
  • Diabetic Retinopathy* / drug therapy
  • Diabetic Retinopathy* / surgery
  • Female
  • Follow-Up Studies
  • Humans
  • Intravitreal Injections
  • Macular Edema* / diagnosis
  • Macular Edema* / drug therapy
  • Macular Edema* / etiology
  • Male
  • Middle Aged
  • Postoperative Complications
  • Ranibizumab / administration & dosage
  • Ranibizumab / therapeutic use
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Vascular Endothelial Growth Factor A* / antagonists & inhibitors
  • Visual Acuity
  • Vitrectomy* / methods

Substances

  • Angiogenesis Inhibitors
  • Bevacizumab
  • Ranibizumab
  • Vascular Endothelial Growth Factor A