Effects Of Laser Photocoagulation Combined With Anti-VEGF Drugs At Different Time In The Treatment Of Diabetic Retinopathy

Objective To investigate the clinical effects of laser photocoagulation combined with treatment with anti-vascular endothelial growth factor(VEGF)drugs at different time in the treatment of diabetic retinopathy(DR).Methods Prospective research.The cases were selected according to the DR diagnostic criteria and the inclusion and exclusion criteria of the subject cases.According to the random number table method,120 cases of 191 eyes with diabetic retinopathy admitted to the Heze Medical College Affiliated Hospital from 2018-01 / 2019-01 were divided into four groups,A,B,C,and D,of which group A was given pure laser photocoagulation,A total of 30 patients,44 eyes;Group B was given intravitreal injection of ranibizumab,a total of 30 patients,46 eyes;Group C was given laser photocoagulation treatment,delayed intravitreal injection of ranibizumab,a total of 30 cases Patients,49 eyes;group D was given delayed laser photocoagulation after intravitreal injection of ranibizumab,a total of 30 patients,52 eyes.The four groups of patients were examined for the best corrected visual acuity(BCVA),intraocular pressure,and macular fovea thickness before treatment.The four groups of patients were followed up for 6 months after laser photocoagulation and / or anti-VEGF drug treatment,respectively,after treatment At 1wk,1,3,and 6mo,the best corrected visual acuity(BCVA),intraocular pressure,and macular fovea thickness were examined,and the best corrected visual acuity(BCVA),intraocular pressure,and macular fovea thickness(CMT)before and after treatment were compared between groups To observe the laser photocoagulation and anti-VEGF treatment and complications and the recurrence of diabetic macular edema.Results Before treatment,there was no difference in BCVA and CMT among the four groups(P> 0.05).After treatment,1wk,1,3,6mo BCVA and CMT were improved compared with before treatment(P <0.05),and patients in groups C and D had better BCVA and CMT than groups A and B at different times after treatment(P <0.05),D The 1wk,1,3mo BCVA and CMT of the group were better than group C(P <0.05).There was no significant change in the intraocular pressure of the four groups before and after treatment(P> 0.05).Retinal laser photocoagulation and intravitreal injection of drugs basically did not cause fluctuations in the intraocular pressure of the patients;the laser parameters and frequency of the patients in groups C and D were lower than A Group,and the laser parameters of group D patients were lower than those of group C(P <0.05),combined treatment can reduce the number of retinal laser photocoagulation,and retinal laser photocoagulation treatment after intravitreal drug injection can reduce laser photocoagulation The energy and other parameters;the number of intravitreal injections of patients in groups C and D is less than that of group B(P <0.05),combined treatment can reduce the number of intravitreal drug injections;but the number of lasers and injections of patients in groups C and D There was no difference(P> 0.05).During the follow-up period,there was no difference in the incidence of complications and recurrence of diabetic macular edema among the four groups(P> 0.05).Conclusion Diabetes is a chronic,life-long disease.As the patient's course progresses,it will cause a series of complications.In the eye,the complication that seriously threatens the patient's visual function is diabetic retinopathy(DR).There are various treatment methods for DR.At present,conservative treatment,laser treatment,intravitreal drug injection,and vitreous surgery are the main methods in the clinic.Laser therapy combined with intravitreal drug injection is the mainstream treatment method.Combined therapy can reduce the number of retinal laser photocoagulation,the number of intravitreal injections,and the parameters of laser photocoagulation.But in the two combined treatments,the treatment method of delayed laser photocoagulation after intravitreal injection of vitreous anti-VEGF drug is more advantageous than the delayed intravitreal injection of ranibizumab after laser photocoagulation.Delayed laser photocoagulation for anti-VEGF drugs after intravitreal injection of DR is better than simple laser photocoagulation,simple intravitreal injection,and delayed intravitreal injection after laser photocoagulation.It can improve patients' BCVA,reduce macular edema,and reduce laser energy and laser frequency And the number of anti-VEGF injections,and the safety is certain.