| Objective: To observe the clinical effects of different treatment regiments in patients with proliferative diabetic retinopathy after vitrectomy,and to provide reference for further clinical treatment.Methods: According to the inclusion and exclusion criteria,60 patients(75 eyes)with type 2 diabetes combined with proliferative diabetic retinopathy who underwent surgical treatment were selected from December 2020 to October 2022 in the inpatient Department of the Ophthalmology Department of the Affiliated Hospital of Yan ’an University.Subjects were divided into two groups: Group A: A total of 35 eyes received 3+PRN treatment,group B: a total of 40 eyes received PRN treatment.Measurement measures related to pre-and post-treatment were collected for all patients.Pre-treatment indicators: general data and fasting blood glucose and glycosylated hemoglobin obtained by laboratory tests were collected.Post-treatment indicators: BCVA(Log MAR),intraocular pressure,and CMT at the end of January,March,and June.The complications of PDR,such as vitreous hemorrhage,neovascularization glaucoma,ocular hypertension,and traction retinal detachment,were also observed.The data were recorded and sorted out.SPSS25.0 software was used to conduct repeated measurement variance analysis of BCVA,intraocular pressure and CMT in the two groups after treatment.Chi-square test was conducted for the occurrence of complications to explore the clinical efficacy of different anti-VEGF treatment schemes on patients.Results:(1)After treatment,the visual acuity of group A gradually improved at the end of first week(1.63±0.99),at the end of January(1.25±0.58),at the end of March(0.95±0.31)and at the end of June(0.75±0.27),with statistical significance(P<0.001).The visual acuity of group B at the end of first week(2.26±0.90),at the end of January(2.10±0.61),at the end of March(2.10±1.07)and at the end of June(3.47±0.86)did not improve and had a trend of decline,the difference was statistically significant(P<0.001).At each time point after treatment,the visual acuity of group A was higher than that of group B,the difference was statistically significant(P <0.05).(2)The intraocular pressure of group A at the end of first week(16.7±11.31),at the end of January(17.71±2.37),at the end of March(18.43±1.33)and at the end of June(16.86±2.77)had no significant fluctuation,and the difference was not statistically significant(P>0.05).The intraocular pressure of group B was gradually increasing at the end of first week(17.13±3.6),the end of January(17.63±2.0),the end of March(25.25±10.7)and the end of June(25.88±12.13),and the difference was statistically significant(P<0.05).The intraocular pressure in group B was higher than that in group A at the end of March and June after treatment,and the difference was statistically significant(P < 0.05).(3)The CMT thickness of group A decreased gradually at the end of the first week(773.29±164.8),at the end of January(356.29±208.7),at the end of March(295.14±129.1)and at the end of June(247.71±35.14),and the data of group A had statistically significant differences(P<0.001).The CMT thickness of group B decreased gradually at the end of 1 week(796.00±116.0),at the end of January(621.63±188.9),at the end of March(479.63±195.2)and at the end of June(505.75±151.5),and the data of group B had statistically significant differences(P<0.001).The CMT thickness of group A was lower than that of group B at each time point after treatment,and the difference was statistically significant(P < 0.05).(4)Complications: rehematoma vitreous(8.6% in group A and 30% in group B);Neovascular glaucoma(5.7% in group A and 22.5% in group B);Ocular hypertension(8.6% in group A and 12.5% in group B);Retinal detachment(Group B 2.5%).Conclusions:(1)In both the 3+PRN and PRN groups,the optimal corrected visual acuity improved after treatment compared to before treatment,and the improved visual acuity was more obvious in the 3+PRN group.(2)In the 3+PRN group,there was no significant change in IOP after treatment compared with before treatment;In the PRN group,the intraocular pressure was higher after treatment than before treatment.Intraocular pressure was higher in PRN group at 3 and 6 months after treatment.(3)In both the 3+PRN group and the PRN group,the foveal retinal thickness decreased after treatment compared with that before treatment,and the retinal thickness decreased more significantly in the 3+PRN group.(4)Within 6 months of follow-up,the incidence of vitreous hemorrhage and neovascularization glaucoma was higher in the PRN group than in the 3+PRN group. |
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