Intravitreal anti-vascular endothelial growth factor agents as an adjunct for proliferative diabetic retinopathy: a systematic review and meta-analysis

作者：Xinzhi Song, Ling Li, Xiangli Wang, Xuemei Zhang, Qihang Lei, Guojun Liu, Lijing Wang, Jiaxiang Chen · 发表于：BMC Ophthalmology · 年份：2025 · DOI：10.1186/s12886-025-04327-x · 被引用次数：3 · 研究领域：Retinal Diseases and Treatments、Retinal and Macular Surgery、Corneal Surgery and Treatments

OBJECTIVE: To evaluate the efficacy and safety of intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents adjunct prior to pars plana vitrectomy (PPV) for patients with proliferative diabetic retinopathy (PDR). METHODS: A systematically comprehensive literature search was performed in PubMed, Embase, Cochrane Library, ClinicalTrials.gov, China National Knowledge Infrastructure (CNKI), Wanfang, VIP Database for Chinese Technical Periodicals, and Chinese Biomedical Literature Database to identify relevant randomized controlled trials (RCTs) up to October 31, 2024. The Peferred Reporting Items for Systematic Reviews and Meta Analysis guidelines were followed. Review Manager 5.4 software was used to conduct statistical analyses. RESULTS: 91 RCTs involving 8721 eyes were included. The intraoperative indices revealed that the amount, grade and incidence of intraoperative bleeding, duration of surgery, the frequency of endodiathermy, the incidences of iatrogenic retinal breaks, endodiathermy, retinotomy, and silicone oil tamponade were significantly less in the PPV + anti-VEGF group than in the PPV group (P < 0.05). Moreover, the postoperative indices showed that anti-VEGF agents adjunct before PPV could achieve better postoperative best corrected visual acuity (BCVA) at different time points, higher postoperative retinal anatomical reattachment, lower postoperative macular retinal thickness (MRT) at different time points and intraocular pressure (IOP) at < 1 month, ...