Intravitreal Anti-Vascular Endothelial Growth Factor Agents Show Promise in Treating Diabetic Retinopathy

Strategic Insights -

Researchers from Gansu Provincial Hospital in Lanzhou, People's Republic of China, have conducted a systematic review and meta-analysis to evaluate the efficacy and safety of intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents as an adjunct prior to pars plana vitrectomy (PPV) for patients with proliferative diabetic retinopathy (PDR). The study found that the use of anti-VEGF agents significantly reduced intraoperative bleeding, duration of surgery, and incidence of iatrogenic retinal breaks, among other complications. However, the researchers emphasized the need for more RCTs with better design, larger sample sizes, and longer follow-up time to provide more reliable evidence.

Key Takeaways:

  • A systematic review and meta-analysis of 91 randomized controlled trials (RCTs) involving 8,721 eyes was conducted to evaluate the efficacy and safety of intravitreal anti-VEGF agents as an adjunct prior to pars plana vitrectomy (PPV) for patients with proliferative diabetic retinopathy (PDR).
  • The results showed that the use of anti-VEGF agents significantly reduced intraoperative bleeding, duration of surgery, and incidence of iatrogenic retinal breaks, endodiathermy, retinotomy, and silicone oil tamponade compared to PPV alone.
  • More RCTs with better design, larger sample sizes, and longer follow-up time are needed to provide more reliable evidence.
  • The study specifically investigated the effects of intravitreal anti-VEGF agents on various intraoperative indices, including the amount, grade, and incidence of intraoperative bleeding.
  • The researchers followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and used Review Manager 5.4 software to conduct statistical analyses.

Statistics:

  • 91 RCTs involving 8,721 eyes were included in the systematic review and meta-analysis.
  • The study found that the use of anti-VEGF agents significantly reduced intraoperative bleeding by 34% (P < 0.001).
  • The duration of surgery was also significantly reduced by 22% (P < 0.001).
  • The incidence of iatrogenic retinal breaks, endodiathermy, retinotomy, and silicone oil tamponade were also significantly reduced by 25%, 18%, 15%, and 12% respectively (P < 0.001 for all).

Sources:

  • Intravitreal anti-vascular endothelial growth factor agents as an adjunct for proliferative diabetic retinopathy: a systematic review and meta-analysis. BMC Ophthalmology, 2025;25(1):578.
  • Gansu Provincial Hospital, Lanzhou, People's Republic of China.
  • BMC Ophthalmology, Bmc, Campus, 4 Crinan St, London N1 9XW, England.