Clinical study of panretinal photocoagulation combined with anti-VEGF drugs in the treatment of severe non proliferative diabetic retinopathy

AIM: To observe the effect of panretinal photocoagulation(PRP)combined with anti-vascular endothelial growth factor(VEGF)drugs in the treatment of severe non proliferative diabetic retinopathy(NPDR), and to investigate the influence of the treatment on the prognosis of NPDR patients.<p>METHODS: Totally 120 patients(227 eyes)with NPDR diagnosed by fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)were randomly divided into observation group(60 cases, 112 eyes)and control group(60 cases, 115 eyes). Patients in the observation group were treated by PRP combined with anti-VEGF drugs, while patients the control group were treated with PRP alone. The clinical efficacy and complications of the two groups were compared. Before and after treatment, the best corrected visual acuity(BCVA), central macular thickness(CMT), levels of serum VEGF and angiopoietin 2(Ang-2)in the two groups were analyzed. <p>RESULTS: The total effective rate of the observation group was significantly higher than that of the control group(<i>P</i><0.05). Compared with before treatment, BCVA of the two groups in the time of 2wk, 1, 3 and 6mo after treatment improved significantly(<i>P</i><0.05). And the BCVA of the observation group at each time point after treatment was better than that of the control group(<i>P</i><0.05). Compared with before treatment, the CMT and the levels of VEGF and Ang-2 in the observation group decreased significantly starting at 2wk after treatment(<i>P</i><0.05). While those in the control group decreased significantly starting at 1mo after treatment(<i>P</i><0.05). The levels of VEGF and Ang-2 in the observation group at each time point after treatment was lower than that of the control group(<i>P</i><0.05). CMT of the observation group were significantly lower than that of the control group in the time of 1, 3 and 6mo after treatment(<i>P</i><0.05). There was no significant difference in the total complication rate between the two groups(<i>P</i>>0.05). <p>CONCLUSION: PRP combined with anti-VEGF drugs could effectively improve vision of NPDR patients, alleviate macular edema, and improve the clinical efficacy