PDVR stage A management: Insights from combined PRP and anti-VEGF treatment outcomes

Abstract

Purpose

To evaluate the outcomes of a combination treatment involving Panretinal photocoagulation (PRP) and Anti-vascular endothelial growth factor (Anti-VEGF) injections in patients with proliferative diabetic vitreoretinopathy (PDVR) at stage A.

Methods

Retrospective, non-randomized case series of patients diagnosed with stage A PDVR who received combination treatment with PRP laser and Anti-VEGF injections were enrolled and analyzed in this study. The principal objective of the study was to qualitatively evaluate the worsening of existing fibrovascular proliferation or recurrence of vitreous hemorrhage (VH), retinal neovascularization (NV), and development of new tractional retinal detachment (TRD). Secondary outcomes were changes in visual acuity before or after treatment.

Results

The study involved 24 eyes from 20 patients with PDVR at stage A and were examined at 4-week and 6-month intervals. The study parameters have shown that the majority of patients (88.72%) either had resolution or stabilization of their retinal diseases. At the 6-month follow-up, worsening of vitreous proliferation traction (VPT) was discovered in 5 eyes (20.8%), while 2 eyes underwent pars plana vitrectomy (PPV). At 4 weeks followup, no new NV emerged in any study eye, however, regrowth of NV was observed in 3 eyes (12.5%) at 6 month followup. Notably, no cases of preretinal hemorrhage (PRH) worsened during the study period. VH was either resolved or stabilized in all study eyes at 4 weeks, but worsening of VH was noted in 2 eyes at the 6-month follow-up. Our treatment showed improvement in logMAR Best corrected visual acuity of patients eyes from baseline to 4 weeks, 6 months, was 0.5 ± 0.41, 0.39 ± 0.34, and 0.32 ± 0.31, respectively.

Conclusion

The combined treatment of PRP laser and Anti-VEGF injections can effectively control the disease progression, stabilize vision, and avoid the need for vitrectomy in early-stage PDVR. Long-term studies are essential to validate the sustained efficacy and safety of this treatment strategy.