治疗多发性糖尿病视网膜病变的外科手术期间的抗VEGF疗法:RCT的网络元分析
Han Qing Zhao1, Wen Da Zhou1, Lei Shao1
1Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Canadian journal of ophthalmology. Journal canadien d'ophtalmologie
|January 31, 2026
概括
术后的抗血管内皮生长因子 (VEGF) 注射可以改善视力,并减少在多发性糖尿病视网膜病变的眼睛手术期间的出血. 最佳时机提供了好处,但证据质量各不相同,需要谨慎的解释.
科学领域:
- 眼科医生 眼科 眼科
- 视网膜疾病 视网膜疾病
- 手术创新 在外科创新.
背景情况:
- 增殖性糖尿病视网膜病变 (PDR) 是视力丧失的主要原因.
- 在PDR手术中,抗血管内皮生长因子 (抗VEGF) 注射是辅助使用的.
- 术后用抗VEGF药物的最佳时间尚不清楚.
研究的目的:
- 为了评估在PDR手术的各种外科手术期间的抗VEGF注射的疗效和安全性.
- 确定不同抗VEGF定时策略对手术结果的影响.
- 评估对视觉敏度,出血和手术持续时间的影响.
主要方法:
- 随机对照试验 (RCT) 的综合网络元分析.
- 搜索了主要的数据库 (PubMed,Cochrane,Embase等等) 在2024年11月之前.
- 包括30项涉及2646只眼睛的研究,独立评估数据,并评估偏差风险.
主要成果:
- 在外科手术期间使用的抗VEGF药物显著改善了多个时间组的最佳校正视敏度 (>7天,3-7天,内科手术).
- 减少复发的玻璃体出血 (手术期间) 和手术期间出血 (手术前>7天).
- 当手术前使用时,手术时间缩短 (>7天而不是1-3天);对使用油或视网膜脱落没有显著影响.
结论:
- 在PDR手术中,经手术的抗VEGF注射提供了显著的优势,包括改善视觉结果和减少出血.
- 临床医生可以根据特定的治疗目标量身定制抗VEGF药物的时间.
- 结论应谨慎解释,因为研究中的异质性和可变的证据质量.
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