Saratov JOURNAL of Medical and Scientific Research

Long-term results of the combined treatment of severe forms of proliferative diabetic retinopathy

Year: 2019, volume 15 Issue: №2 Pages: 550-555
Heading: Ophtalmology Article type: Original article
Authors: Tereshhenko. A.V., Sidorova Yu.A., Zhukova O.M., Firsova V.V.
Organization: S. Fedorov Eye Microsurgery Federal State Institution, Kaluga Branch

Purpose: to evaluate the results of fve-year follow-up of patients with proliferative diabetic retinopathy after combined treatment using intravitreal administration of angiogenesis inhibitors and subtotal panretinal laser coagulation of the retina. Material and Methods. The study included 42 patients (42 eyes) with severe forms of proliferative diabetic retinopathy. In all cases, the frst step was intravitreal administration of an angiogenesis inhibitor (IVV AI) of-label. The second stage was carried out sessions of panretinal laser coagulation (PRLK), with the frst session — no later than two weeks after the IVV AI. Subsequent sessions of laser treatment were carried out with an interval of 1.5–2 months before the completion of subtotal PRLK (3 sessions). In the course of further follow-up, additional treatment was performed as necessary. The observation period was 5 years. Results. By the end of the observation period, complete regression of retinovitreal neovascularization and neovascularization of the optic nerve head was observed on 39 and 32 eyes (92.8 and 76.2 % respectively). During the observation period, all patients underwent subtotal PRLK, additional sessions of laser treatment were required in 19 cases (45.2 %), of which in 12 cases 1 additional session was performed, in 7 cases — 2 sessions of PRLP each. IVV AI was performed once in all cases, in 11 cases (26.2 %) additional injections were required, with the largest number of injections performed during the frst 2 years. Conclusion. The proposed algorithm for the management and treatment of severe forms of proliferative diabetic retinopathy has demonstrated its efectiveness, as evidenced by fve-year observation data.

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