Treatment of severe proliferative diabetic retinopathy with Ranibizumab injection and vitrectomy

Objective To evaluate the clinical efficacy and security of Ranibizumab intravitreal injection and vitrectomy for severe proliferative diabetic retinopathy(PDR). Methods Forty eyes of 32 cases with severe PDR were selected and analyzed retrospectively as the trial group, and they received intravitreal injection of 0.5 mg Ranibizumab before 3 days vitrectomy. Thirty-eight eyes of 30 cases with PDR in same period were selected as control group, and they received vitrectomy only. The central macular retinal thickness(CMT), visual acuity, intraocular pressure and complications were observed and compared during the follow-up. Results The visual acuity (log MAR, BCVA) was 1.40±0.03, the CMT was (353.7±32.6)μm before surgery in trial group, and 1.00±0.04, (310.2± 28.7) μm at 1 month after surgery, respectively. The visual acuity was 1.40±0.04, the CMT was (352.9± 35.1) μm before surgery in control group, and 1.20±0.04, (326.7± 25.6)μm at 1 month after surgery, respectively. There was no significant difference in visual acuity or CMT between the two groups before surgery(t=0.00, 0.10; P=1.00, 0.92). The visual acuity and CMT in the trial group were better than those in the control group after operation(t=-22.07, -2.67; P=0.00, 0.01). There was no statistical difference in intraocular pressure between the two groups before and after operation(t=-0.43, -0.72; P=-0.67, 0.47), but the incidence rate of vitreous hemorrhage in trial group was lower than that of control group (χ2=4.72, P=0.03). Conclusion Ranibizumab injection and vitrectomy can effectively improve the visual acuity, reduce CMT and complications of severe PDR. Key words: Retinopathy, diabetic, proliferative, severe; Ranibizumab, intravitreal injection; Vitrectomy