Skip to main content
Top
Published in: BMC Ophthalmology 1/2020

Open Access 01-12-2020 | Diabetic Retinopathy | Research article

The effect of adjunctive intravitreal conbercept at the end of diabetic vitrectomy for the prevention of post-vitrectomy hemorrhage in patients with severe proliferative diabetic retinopathy: a prospective, randomized pilot study

Authors: Tingting Jiang, Junxiang Gu, Peijun Zhang, Wenwen Chen, Qing Chang

Published in: BMC Ophthalmology | Issue 1/2020

Login to get access

Abstract

Background

To investigate the effect of intravitreal conbercept (IVC) injections on the incidence of postoperative vitreous hemorrhage (VH) in eyes undergoing surgery for severe proliferative diabetic retinopathy.

Methods

This was a pilot prospective, comparative, and randomized study. Thirty patients, who underwent vitrectomy for severe proliferative diabetic retinopathy, were assigned randomly to either group 1 (intravitreal conbercept [IVC] injection at the end of pars plana vitrectomy) or group 2 (no IVC injection). Postoperative follow-up was performed on the first day, first week, first month, third month, sixth month and first year after surgery. The primary outcome was the incidence of postoperative VH. Secondary outcomes were the initial time of vitreous clearing (ITVC), best-corrected visual acuity (BCVA) and central retinal thickness (CRT) after surgery.

Results

A total of 30 eyes, from 30 patients, were included. Fifteen eyes were enrolled in the IVC group and fifteen in the control group. The incidence of early and late postoperative VH was not significantly different between the control and IVC groups. ITVC was shorter in the IVC group than that in the control group, but this was not significant (7.38 ± 10.66 vs 13.23 ± 17.35, P = 0.31). Final BCVA, 1 year after surgery, showed significant improvement compared to baseline in both groups. However, analysis of the BCVA at any postoperative visit after surgery showed no significant differences between the two groups. There were two cases of recurrent VH identified at 3 and 6 months after surgery in each group, requiring a second round of surgery. Foveal thickness was significantly different between the two groups at the 3-month, 6-month and 1-year follow-up visits.

Conclusions

In this pilot study, the effect of IVC injection in reducing the incidence of postoperative VH after diabetic vitrectomy at the end of vitrectomy was not shown.

Trial registration

The study was registered with the Chinese Clinical Trial Registry. (Reference Number: ChiCTR1800015751​).
Literature
1.
go back to reference Schachat AP, Oyakawa RT, Michels RG, Rice TA. Complications of vitreous surgery for diabetic retinopathy. II. Postoperative complications. Ophthalmology. 1983;90(5):522–30.CrossRefPubMed Schachat AP, Oyakawa RT, Michels RG, Rice TA. Complications of vitreous surgery for diabetic retinopathy. II. Postoperative complications. Ophthalmology. 1983;90(5):522–30.CrossRefPubMed
2.
go back to reference de Bustros S, Glaser BM, Michels RG, Auer C. Effect of epsilon-aminocaproic acid on postvitrectomy haemorrhage. Arch Ophthalmol. 1985;103(2):219–21.CrossRefPubMed de Bustros S, Glaser BM, Michels RG, Auer C. Effect of epsilon-aminocaproic acid on postvitrectomy haemorrhage. Arch Ophthalmol. 1985;103(2):219–21.CrossRefPubMed
4.
go back to reference Joondeph BC, Blankenship GW. Haemostatic effects of air versus fluid in diabetic vitrectomy. Ophthalmol. 1989;96(12):1701–6.CrossRef Joondeph BC, Blankenship GW. Haemostatic effects of air versus fluid in diabetic vitrectomy. Ophthalmol. 1989;96(12):1701–6.CrossRef
5.
go back to reference Koutsandrea CN, Apostolopoulos MN, Chatzoulis DZ, Parikakis EA, Theodossiadis GP. Haemostatic effects of SF6 after diabetic vitrectomy for vitreous haemorrhage. Acta Ophthalmol Scand. 2001;79(1):34–8.CrossRefPubMed Koutsandrea CN, Apostolopoulos MN, Chatzoulis DZ, Parikakis EA, Theodossiadis GP. Haemostatic effects of SF6 after diabetic vitrectomy for vitreous haemorrhage. Acta Ophthalmol Scand. 2001;79(1):34–8.CrossRefPubMed
12.
go back to reference Romano MR, Gibran SK, Marticorena J, Wong D, Heimann H. Can an intraoperative bevacizumab injection prevent recurrent postvitrectomy diabetic vitreous hemorrhage? Eur J Ophthalmol. 2009;19(4):618–21.CrossRefPubMed Romano MR, Gibran SK, Marticorena J, Wong D, Heimann H. Can an intraoperative bevacizumab injection prevent recurrent postvitrectomy diabetic vitreous hemorrhage? Eur J Ophthalmol. 2009;19(4):618–21.CrossRefPubMed
13.
go back to reference Jirawison C, Ittipunkul N. Intravitreal Bevacizumab at the end of diabetic-Vitrectomy for prevention of postoperative vitreous hemorrhage: a comparative study. J Med Assoc Thail. 2012;95(Suppl 4):S136–42. Jirawison C, Ittipunkul N. Intravitreal Bevacizumab at the end of diabetic-Vitrectomy for prevention of postoperative vitreous hemorrhage: a comparative study. J Med Assoc Thail. 2012;95(Suppl 4):S136–42.
16.
go back to reference Novak MA, Rice TA, Michels RG, Auer C. Vitreous hemorrhage after vitrectomy for diabetic retinopathy. Ophthalmology. 1984;91(12):1485–9.CrossRefPubMed Novak MA, Rice TA, Michels RG, Auer C. Vitreous hemorrhage after vitrectomy for diabetic retinopathy. Ophthalmology. 1984;91(12):1485–9.CrossRefPubMed
17.
go back to reference Tolentino FI, Cajita VN, Gancayco T, Skates S. Vitreous hemorrhage after closed vitrectomy for proliferative diabetic retinopathy. Ophthalmology. 1989;96(10):1495–500.CrossRefPubMed Tolentino FI, Cajita VN, Gancayco T, Skates S. Vitreous hemorrhage after closed vitrectomy for proliferative diabetic retinopathy. Ophthalmology. 1989;96(10):1495–500.CrossRefPubMed
22.
go back to reference Simó R, Carrasco E, García-Ramírez M, Hernández C. Angiogenic and antiangiogenic factors in proliferative diabetic retinopathy. Curr Diabetes Rev. 2006;2(1):71–98.CrossRefPubMed Simó R, Carrasco E, García-Ramírez M, Hernández C. Angiogenic and antiangiogenic factors in proliferative diabetic retinopathy. Curr Diabetes Rev. 2006;2(1):71–98.CrossRefPubMed
23.
go back to reference Funatsu H, Yamashita H, Ikeda T, et al. Vitreous levels of interleukin-6 and vascular endothelial growth factor are related to diabetic macular edema. Ophthalmology. 2003;110(9):1690–6.CrossRefPubMed Funatsu H, Yamashita H, Ikeda T, et al. Vitreous levels of interleukin-6 and vascular endothelial growth factor are related to diabetic macular edema. Ophthalmology. 2003;110(9):1690–6.CrossRefPubMed
24.
go back to reference Adamis AP, Miller JW, Bernal MT, et al. Increased vascular endothelial growth factor levels in the vitreous of eyes with proliferative diabetic retinopathy. Am J Ophthalmol. 1994;118(4):445–50.CrossRefPubMed Adamis AP, Miller JW, Bernal MT, et al. Increased vascular endothelial growth factor levels in the vitreous of eyes with proliferative diabetic retinopathy. Am J Ophthalmol. 1994;118(4):445–50.CrossRefPubMed
26.
go back to reference Lu H, Cui J, Dong H, et al. Clinical observation of a new anti-VEGF drugs conbercept for wet age-related macular degeneration. Chinese J Ophthalmol. 2015;51(11):818–21. Lu H, Cui J, Dong H, et al. Clinical observation of a new anti-VEGF drugs conbercept for wet age-related macular degeneration. Chinese J Ophthalmol. 2015;51(11):818–21.
27.
go back to reference Zhang M, Zhang J, Yan M, et al. Recombinant anti-vascular endothelial growth factor fusion protein efficiently suppresses choridal neovascularization in monkeys. Mol Vis. 2008;10(4):37–49. Zhang M, Zhang J, Yan M, et al. Recombinant anti-vascular endothelial growth factor fusion protein efficiently suppresses choridal neovascularization in monkeys. Mol Vis. 2008;10(4):37–49.
34.
go back to reference Suganami E, Takagi H, Ohashi H, et al. Leptin stimulates ischemia-induced retinal neovascularization: possible role of vascular endothelial growth factor expressed in retinal endothelial cells. Diabetes. 2004;53(9):2443–8.CrossRefPubMed Suganami E, Takagi H, Ohashi H, et al. Leptin stimulates ischemia-induced retinal neovascularization: possible role of vascular endothelial growth factor expressed in retinal endothelial cells. Diabetes. 2004;53(9):2443–8.CrossRefPubMed
39.
go back to reference Zhao X, Yang G, Yang J, Zhang J. Effect of intravitreal conbercept vs triamcinolone acetonide at the end of surgery on macular structure and function in patients with severe proliferative diabetic retinopathy. Int J Clin Exp Med. 2017;10(10):14511–8. Zhao X, Yang G, Yang J, Zhang J. Effect of intravitreal conbercept vs triamcinolone acetonide at the end of surgery on macular structure and function in patients with severe proliferative diabetic retinopathy. Int J Clin Exp Med. 2017;10(10):14511–8.
Metadata
Title
The effect of adjunctive intravitreal conbercept at the end of diabetic vitrectomy for the prevention of post-vitrectomy hemorrhage in patients with severe proliferative diabetic retinopathy: a prospective, randomized pilot study
Authors
Tingting Jiang
Junxiang Gu
Peijun Zhang
Wenwen Chen
Qing Chang
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2020
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/s12886-020-1321-9

Other articles of this Issue 1/2020

BMC Ophthalmology 1/2020 Go to the issue