Coherent Optical Tomography Angiography Observation Of Pure Retina Laser Photocoagulation And Anti-vascular Endothelial Growth Factor Drugs Combined With Laser Treatment On The Inhibitory Effect Of Neovascularization In Proliferative Diabetic Retinopathy

Objective To investigate the inhibitory effects of panretinal photocoagulation(PRP)alone and intravitreal anti vascular endothelial growth factor(VEGF)combined with PRP on neovascularization of proliferative diabetic retinopathy(PDR)using optical coherence tomography angiography(OCTA).Methods Case-control studies.PDR patients with neovascularization were confirmed by fluorescein fundus angiography and OCTA were selected.According to the wishes of patients,they were treated by PRP alone or anti-VEGF drugs combined with PRP.Automated Quantification of neovascularization using OCTA was performed before,during,and after treatment.Statistical analysis of changes in neovascularization after each group was performed,and the effects of the two groups were compared.Results In 29 eyes of PRP group,the mean best corrected visual acuity(BCVA)at baseline was 0.49,and the mean neovascular area was 1.395 mm2.Compared with baseline,the BCVA difference at 3 months after PRP was statistically significant;the neovascular area differences during PRP and 3 months after PRP were statistically significant.Compared with the previous time point,BCVA at 1 month and 3 months was significantly increased,and the area of neovascularization before the second PRP was significantly reduced.In 9 eyes of the combined therapy group,the mean BCVA at baseline was 0.58,and the mean neovascular area was 3.761 mm2.Compared with baseline,there was no statistically significant difference in BCVA during and after therapy.Neovascular regression was statistically significant during and 3 months after PRP.Compared with the previous time point,there was no significant change in BCVA,and the area of neovascularization before the 1st and 3rd PRP were significantly reduced.Comparing the data between the two groups during and after therapy,all BCVA differences were not statistically significant.In addition,the ratio of neovascularization was significantly reduced in the combined therapy group during PRP and at 3 months,6 months after PRP.Conclusions The advantages of combination therapy are obvious,and it can maintain a strong inhibitory effect on neovascularization both in the short and long term.OCTA can obtain high-resolution images of neovascularization and quantify them in most PDR patients,which may be clinically useful in evaluating the therapeutic effect.