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| Effect of Intravitreal Ranibizumab-assisted PPV on Proliferative Diabetic Retinopathy and Its Effects on Cell Factors in Aqueous Humor |
| ZHANG Qi-ming, RUAN Xue-wu |
| Department of Ophthalmology, the Wuhan Sixth Hospital Affiliated to Jianghan University, Hubei 430015 |
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Abstract 【Objective】 To observe the efficacy of intravitreal injection of Ranibizumab in assisted Pars Plana Vitrectomy (PPV) for proliferative diabetic retinopathy (PDR) , and the effect on levels of vascular endothelial growth factor (VEGF), interleukin-6 (IL-6), IL-8 and monocyte chemokine protein-1 (MCP-1) .【Methods】 One hundred and forty-six patients with PDR (all monocular diseases) admitted to our hospital from June 2015 to June 2017 were selected and randomly divided into three groups: A, B and C. In the group A, 50 cases (50 eyes) were treated with PPV 4 days after Razumab injection; in the group B, 48 cases (48 eyes) were treated with PPV 10 days after Razumab injection; and in the group C, 48 cases (48 eyes) were treated with PPV operation only. The therapeutic effect was observed and the levels of vascular endothelial growth factor, interleukin-6, interleukin-8 and MCP-1 were compared before and after treatment. 【Results】 The operation time of the group A and group B was significantly shorter than that of the group C (P<0.05); the average bleeding times, electrocoagulation times and silicone oil filling rate were significantly less than those of the group C (P<0.05); but there was no significant difference in operation time, average bleeding times, electrocoagulation times and silicone oil filling rate between the group A and the group B (P>0.05). The incidence of vitreous hemorrhage and iatrogenic retinal hole in the group A and B was significantly lower than that in the group C (P<0.05); the proportion of patients with visual acuity of 0.3~0.5 and > 0.5 in the group A and B was significantly higher than that in the group C (P<0.05); the ratio of manual operation and anterior ocular index in the group A and B was significantly lower than that in the group C (P<0.05); the average intraocular pressure in the group A and B was significantly lower than that in the group C (P<0.05). Visual acuity was significantly higher than that of the group C (P<0.05), but there was no significant difference between the group A and the group B (P>0.05). On the 7th day after treatment, the levels of VEGF and IL-18 in aqueous humor of the group A and the group B were significantly lower than those of the group C, and the levels of IL-6 and MCP-1 were significantly higher than those of the group C (P<0.05), but there was no significant difference between the group A and the group B (P>0.05).【Conclusion】 The intravitreal injection of Ranibizumab-assisted PPV is effective in the treatment of proliferative diabetic retinopathy. It can effectively improve the visual acuity of patients, and has a high application value. It is an ideal time for injection 4 days before surgery.
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Received: 16 May 2018
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2019, Vol. 36 
