ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR PROLIFERATIVE DIABETIC RETINOPATHY: A Systematic Review and...

Area of Science:

• Ophthalmology
• Diabetic Retinopathy Management
• Vascular Endothelial Growth Factor Inhibition

Background:

• Proliferative diabetic retinopathy (PDR) is a leading cause of vision loss.
• Anti-vascular endothelial growth factor (anti-VEGF) agents are increasingly used in managing retinal diseases.
• Evidence for anti-VEGF efficacy in PDR requires systematic evaluation.

Purpose of the Study:

• To systematically review and meta-analyze randomized controlled trials (RCTs) of anti-VEGF agents in PDR management.
• To assess the impact of anti-VEGF agents on visual acuity, surgical outcomes, and structural changes.

Main Methods:

• Systematic review and meta-analysis of 22 RCTs involving 1,397 participants.
• Inclusion of studies using anti-VEGF agents as standalone or combined therapy.
• Primary outcomes: best-corrected visual acuity, surgery duration, postoperative vitreous hemorrhage. Secondary outcomes: central retinal thickness, intraoperative variables.

Main Results:

• High-quality evidence shows anti-VEGF with pan-retinal photocoagulation (PRP) improves visual acuity and reduces central retinal thickness.
• Moderate-quality evidence indicates anti-VEGF before vitrectomy (PPV) significantly reduces surgery duration, retinal breaks, and intraoperative bleeding.
• Low-quality evidence suggests a potential reduction in early postoperative vitreous hemorrhage.

Conclusions:

• Anti-VEGF agents as adjuncts to PRP and PPV improve functional and structural outcomes in PDR.
• Preoperative anti-VEGF facilitates procedures and may minimize iatrogenic damage.
• Further research is needed to confirm benefits for early postoperative vitreous hemorrhage.