| Purpose:To evaluate the regression of RNV after use of renibizumab plus PRP in eyes withPDR.To explor pathogenesis of PDR.To evaluate the advantages and adverse reactions ofthe combination therapy.Methods:Retrospective study was conducted in42eyes of36patients with PDR,and no priorlaser treatment.20eyes of20patients were treated with intravitreal renibizumab o.5mgfirst,7days later the first session of PRP was given.Then PRP was finished once a weekduration a month.22eyes of16cases were treated with PRP only,underwent one sessionevery7days,a total of4times to complete.Patients received complete ophthalmicevaluation,includind best-corrected visual acuity(BCVA), intraocular pressure(IOP)，fundus fluorescein angiography（FFA），optical coherence tomography（OCT）.All of theevaluation were performed at baseline and at month1,3,6,9after PRP was finished.Results:1Thirty-six patients completed9months follow-up after PRP.There was nosignificant difference between the two groups with respect to age,gender,duration of DM.2The BCVA of the combined treatment group improved from the baseline of4.56±0.25to4.80±0.19,4.81±0.17,4.75±0.18,4.72±0.17at the point of1,3,6,9months afterPRP respectively.Final BCVA analysis demonstrated that9eyes(45%) improved,10eyes(50%) remained stable，1eye decreased2lines at the6months follow-up.The BCVAof the PRP group was4.61±0.27at baseline,there was no significant difference of BCVAafter PRP.22eyes of16patients only5eyes(22.72%) improved BCVA,12eyes(12.54%)remained stable,5eyes(22.72%) decreased of BCVA.3The RNV area of combination group from (11.68±9.99)mm2of baseline to(2.42±2.39) mm2，(3.40±2.84)mm2,(5.01±4.40)mm2（,6.24±6.58） mm2at the4time point after PRP,there is a statistically significant decrease of the area in all time point（.P<0.01）.The RNV area of PRP group was （5.54±3.41）mm2at baseline,at1,3,6,9months the areawere（4.74±3.10）mm2，（4.15±2.65）mm2，（3.91±2.58）mm2,（3.94±2.53）mm2respectively.there was no significant difference after PRP.4The IOP of combination group was（17.75±1.55）mmhg at baseline、（18.45±1.35）mmhg、（17.95±2.66）mmhg、（18.50±2.09）mmhg、（18.50±1.23）mmhg at the1,3,6,9months of follow-up..The IOP of PRP group was（16.59±1.56）mmhg，（17.45±1.40）mmhg、（17.18±1.29）mmhg、（17.86±1.45）mmhg、（17.86±1.52）mmhg at the1,3,6,9months after PRP. There was no significant difference after PRP of the twogroups.(P>0.05)5At months1,3,6,9the CRT of combination group was（140.25±11.14）μm、（140.65±8.86）μm、（146.75±10.25）μm、,decreased from（173.6±42.69）μm atbaseline(p<0.05).The CRT of the9month was（153.6±11.74）μm,no significant decreasefrom the baseline(P>0.05).CRT of PRP group was（176.68±39.87）μm befor PRP.（180.68±44.13）μm、（198.45±59.21）μm、（193.82±61.49）μm、（185.91±48.18）μm at month1,3,6,9after PRP.No significant difference after PRP（P>0.05）。Conclusions:ranibizumab eliminated active RNV effectively,reduced retinal edema and improvedvisual acuity. ranibizumab could reduce the chance of vitreous hemorrhage so that PRPcould be completed safely.The combination of ranibizumab with PRP achieved goodresults than PRP alone in PDR patients. |
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