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Efficacy comparison of intravitreal injections of conbercept and ranibizumab for severe proliferative diabetic retinopathy

Published:August 25, 2018DOI:https://doi.org/10.1016/j.jcjo.2018.06.010

      Abstract

      Objective

      To determine the efficacy of preoperative intravitreal injections of conbercept (IVC) and ranibizumab (IVR) on postoperative best-corrected visual acuity (BCVA), vitreous hemorrhage (VH), and neovascular glaucoma (NVG) in a population with proliferative diabetic retinopathy (PDR) undergoing vitrectomy.

      Design

      Retrospective, cross-sectional study.

      Participants

      386 patients with severe PDR (428 eyes).

      Methods

      The patients who did not receive IVC or IVR were assigned to group A (125 eyes), the patients who received IVR (0.5 mg) were assigned to group B (146 eyes), and the patients who received IVC (0.5 mg) were assigned to group C (157 eyes).

      Results

      Both group B (p = 0.009) and group C (p = 0.002) had better postoperative BCVA than group A. Early postoperative VH occurred significantly less frequently in group B (22.60%; p = 0.007) and group C (12.10%; p < 0.001) than in group A (37.60%). Importantly, the incidences of postoperative NVG in group B (2.74%; p = 0.001) and group C (0.64%; p < 0.001) were both significantly less than that in group A (15.20%). However, there was no significant difference in the incidences of postoperative NVG between groups B and C (p = 0.325).

      Conclusions

      The contribution of preoperative IVC to an improved BCVA for patients with severe PDR was better than that of IVR, and IVC decreased the risk of postoperative early VH. Pretreatment with IVC or IVR reduced the incidence of postoperative NVG based on the 24-month follow-up data.

      Résumé

      Objectif

      Déterminer l'efficacité des injections intravitréennes préopératoires de conbercept (CIV) et de ranibizumab (RIV) sur la meilleure acuité visuelle corrigée (MAVC), l'hémorragie vitréenne (HV) et le glaucome néovasculaire (GNV) postopératoires chez des sujets présentant une rétinopathie diabétique proliférante (RDP) qui devaient subir une vitrectomie.

      Nature

      Étude transversale rétrospective.

      Participants

      386 patients présentant une RDP grave (428 yeux).

      Méthodes

      Les patients qui n'avaient reçu ni CIV ni RIV formaient le groupe A (125 yeux); ceux qui avaient reçu le RIV (0,5 mg) formaient le groupe B (146 yeux); et ceux qui avaient reçu le CIV (0,5 mg) formaient le groupe C (157 yeux).

      Résultats

      La MAVC postopératoire des sujets des groupes B (p = 0,009) et C (p = 0,002) était supérieure à celle des sujets du groupe A. Il s'est produit significativement moins de cas d'HV postopératoire précoce dans le groupe B (22,60 %; p = 0,007) et dans le groupe C (12,10 %; p < 0,001) que dans le groupe A (37,60 %). Fait important, l'incidence de GNV postopératoire était significativement moindre dans les groupes B (2,74 %; p = 0,001) et C (0,64 %; p < 0,001) comparativement au groupe A (15,20 %). Cela dit, on n'a enregistré aucune différence significative quant à l'incidence de GNV postopératoire entre les groupes B et C (p = 0,325).

      Conclusions

      En présence de RDP grave, l'administration préopératoire de CIV a procuré une amélioration supérieure de la MAVC comparativement au RIV, sans compter que le CIV a réduit le risque d'HV postopératoire précoce. Selon les données du suivi à 24 mois, l'administration préalable de CIV ou de RIV a réduit l'incidence de GNV postopératoire.
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