Intravitreal injection with Ranibizumab combined with extra panrentinal photocoagulation for proliferative diabetic retinopathy with disc neovascularization

AIM: To evaluate the therapeutic effect of intravitreal injection of ranibizumab(IVR)combined with extra panrentinal photocoagulation(E-PRP)for diabetic neovascularization on the disc(DNVD). METHODS: A total of 36 eyes of 32 patients with DNVD underwent IVR combined with E-PRP. The examinations of visual acuity, funds fluorescein angiography(FFA)and optical coherence tomography(OCT)were performed on all of the patients before and 6mo after the treatment; the result of the examinations before and after the treatment were compared and analyzed. RESULTS: Before the treatment, best corrected visual acuity(BCVA, LogMAR)was 0.89±0.35, 6mo after treatment was 0.42±0.13; the difference was significant(P<0.01). After the treatment, BCVA was improved in 19 eyes(53%), unchanged in 14 eyes(39%)and decreased in 3 eyes(8%). Retinal nerve fiber layer(RNFL)was 110.64±12.06μm at 6mo after IVR+E-PRP, which was significantly different to those before treatment and 7d after treatment(t=5.612, 3.304; P<0.05). Neovascularization regressed in 32 eyes(89%), and unchanged or aggravated in 4 eyes(11%). The results of FFA after E-PRP showed that the one-off efficiency of E-PRP was 69%(25 eyes), 7 eyes(19%)need an additional laser, in which 4 eyes(11%)underwent vitreous surgery. CONCLUSION: IVR combined with E-PRP as a treatment for DNVD may improve the regression of retinal neovascularization and the reduction of vascular permeability, and improve the therapeutic effect and safety.