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With the increasing incidence of proliferative diabetic retinopathy (PDR), subsequent neovascular glaucoma (NVG) has become one of the main causes of blindness in PDR patients, and the intraocular pressure of PDR patients with NVG is often stubborn. For these patients, not only is the effect of drugs in lowering intraocular pressure poor, but the results of surgery are often unsatisfactory. Because of its poor prognosis, clinical research for better strategy is of great significance in the current situation. At present, for such patients, a combination of effective control of intraocular pressure and treatment of the primary disease is often used. The purpose of this study was to investigate the clinical effects of preoperative with/without intraoperative anti-vascular endothelial growth factor (VEGF) drug therapy combined with pars plana vitrectomy (PPV), pan-retinal photocoagulation (PRP), and pressure-reducing valve implantation in patients with NVG secondary to PDR. Furthermore, the changes of neurotrophic factors in the vitreous humor before and after anti-VEGF treatment will be explored.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| pre-vitrectomy anti-VEGF injection group | Experimental | Patient in this group receive an intravitreal injection of anti-VEGF drug 3-5 days before surgery, followed by PPV combined with PRP and pressure-reducing valve implantation |
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| pre and post-vitrectomy anti-VEGF injection group | Experimental | Patient in this group receive two intravitreal injections of anti-VEGF drugs. One is injected 3-5 days before surgery, the other is at the same time as the PPV combined with PRP and pressure reducing valve implantation is completed. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| anti-VEGF | Drug | To explore whether adding post-vitrectomy anti-VEGF agent injection can reach a better prognosis in PDR patients with NVG who underwent PPV combined with PRP and pressure-reducing valve implantation |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in Best Corrected Visual Acuity from baseline to 12 months after surgery | Follow-up on the first day, first week, 1, 3, 6, 9 and 12 months after surgery | |
| Changes in Intraocular Pressure from baseline to 12 months after surgery | Follow-up on the first day, first week, 1, 3, 6, 9 and 12 months after surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in Neovascularization Recurrence Rate from baseline to 12 months after surgery | Follow-up on the first day, first week, 1, 3, 6, 9 and 12 months after surgery | |
| Changes in Ocular and Systemic Adverse Events from baseline to 12 months after surgery |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Xi Shen | Ruijin Hospital, Affiliated Shanghai Jiaotong University School of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, | Shanghai | China |
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| ID | Term |
|---|---|
| D015355 | Glaucoma, Neovascular |
| ID | Term |
|---|---|
| D005901 | Glaucoma |
| D009798 | Ocular Hypertension |
| D005128 | Eye Diseases |
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| Follow-up on the first day, first week, 1, 3, 6, 9 and 12 months after surgery |