| Objective:To investigate the efficacy and safety of retinal photo-coagulation alone and the combined retinal photo-coagulation with the aflibercept 3+PRN regimen versus the 5+PRN regimen in patients with high-risk proliferative diabetic retinopathy(PDR)combined with DME.Method:170 eyes of 170 patients with high-risk PDR combined with DME attending our ophthalmology clinic from December 2018 to December 2020 were collected and divided into PRP group(n=58),aflibercept 5+PRN combined with PRP group(n=53),aflibercept 3+PRN combined with PRP group(n=59).General information such as patients’ age,gender,and eye category;as well as best-corrected visual acuity(BCVA),baseline central macular concavity thickness(CFT),microaneurysm(MA),area of neovascularization(NV),area of hard exudate(HE),and cytokine levels in atrial fluid before and after treatment were collected,and all information except the number of injections was not statistically different between the two groups.The χ2 test was used for comparison between groups for statistical data,ANOVA was used for statistical description of measurement data,and t-test for independent samples and Student-Newman-Keuls test were used for comparison between groups,and differences were considered statistically significant at P<0.05.Results:After treatment,there was no significant improvement in BCVA(log MAR)in the PRP group compared with that before treatment;while BCVA(log MAR)decreased from(0.72±0.17)and(0.74±0.17)to(0.50±0.13)and(0.53±0.17)in the combination laser group of aflibercept 5+PRN and the combination laser group of aflibercept 3+PRN,respectively,and the differences were statistically significant(P<0.05;P<0.05);there was a statistically significant difference between the combined group compared with the PRP group(P<0.05;P<0.05),but there was no statistically significant difference between the two combined groups compared(P>0.05).The CFT in the laser group decreased slightly from(361.80±36.70)μm to(353.86±40.88)μm,with no statistically significant difference(P>0.05),while the CFT in the aflibercept 5+PRN combined PRP group and aflibercept 3+PRN combined PRP group decreased from(356.57±37.57)μm,(358.17±44.66)μm to(284.87±31.52)μm and(303.19±37.00)μm,respectively,with statistically significant differences before and after treatment(P<0.05;P<0.05);and statistically significant differences between the three groups compared to each other after treatment(P<0.05;P<0.05;P<0.05).the PRP group,the aflibercept 5+PRN combined PRP group,and aflibercept 3+PRN combined PRP group,the number of MA(pcs)decreased from(118.34±27.96),(118.60±33.34),and(116.59±28.95)to(92.95±29.04),(44.60±20.73),and(54.26±25.43),respectively;the two-way comparison of the sample means of the three groups The differences were all statistically significant(P<0.05;P<0.05;P<0.05).The area of retinal neovascularization decreased in all three groups,from(1.00±0.21)mm~2,(1.01±0.18)mm~2,and(0.98±0.20)mm 2 before treatment to(0.49±0.17)mm 2,(0.31 ±0.16)mm~2,and(0.38±0.14)mm~2,respectively,and the differences were statistically significant before and after treatment(P<0.05,P<0.05,P<0.05).After 12 months of treatment,there were 13 patients with reduced HE area in the PRP group;18 patients with reduced HE area in the 5+PRN combined with PRP group;and 18 patients with reduced HE area in the 3+PRN combined with PRP group;the differences were statistically significant(P<0.05,P<0.05,P<0.05).After 12 months of treatment,VEGF,MCP-1,and GFAP levels(pg/mL)in atrial fluid decreased in both combined groups compared with baseline,and the differences were statistically significant,but there was no significant difference between the two combined groups(P>0.05).Conclusion:The aflibercept 5+PRN combined with PRP group was safe and effective in treating patients with diabetic retinopathy with high-risk PDR combined with DME,and was more effective than the PRP group and the aflibercept 3+PRN combined with PRP group in improving central macular fovea thickness(CFT)and microaneurysm(MA). |
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