The British journal of ophthalmology · 2026
Microinvasive pars plana vitrectomy versus panretinal photocoagulation for severe non-proliferative diabetic retinopathy: a randomised controlled trial.
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Lin Zhuangling, Zheng Wenbin, Ding Xiaohu, Liu Baoyi, Jin Ling, Lai Kunbei, Xiao Sainan, Lin Ying, Liu Bingqian, Li Jizhu, Ma Yuan, Wu Yuqing, Liu Yuan, Meng Yang, Li Yujie, Chen Shida, Li Tao
Аннотация
PURPOSE: To evaluate the progression rate of severe non-proliferative diabetic retinopathy (sNPDR) in eyes treated with microinvasive pars plana vitrectomy (PPV) versus panretinal photocoagulation (PRP) over 12 months.
METHODS: 55 eyes of 55 diabetic patients aged >18 years with sNPDR were randomised 1:1 to the PPV group (n=27) or the PRP group (n=28). Standard 25G PPV was performed by an experienced surgeon within 4 weeks of enrolment. Standard PRP was performed in three sessions within 4 weeks of enrolment. The primary outcome was the proportion of eyes progressed from sNPDR to proliferative diabetic retinopathy (PDR) over 12 months.
RESULTS: A total of 27 participants (mean (SD) age, 61.19 (8.89) years; 16 male (59.3%)) in the PPV group and 28 participants (mean (SD) age, 60.50 (7.93) years; 11 male (39.3%)) in the PRP group were analysed. At 12 months, no patients in the PPV group progressed to PDR, compared with 2 of 28 patients (7.1%) in the PRP group (p=0.49). The mean (SD) change in total visual field point score was -16.70 (415.23) dB in the PPV group and -314.00 (404.59) dB in the PRP group (p=0.02). For the peripheral 60-4 test, the mean (SD) change was -11.39 (167.99) dB in the PPV group versus -207.05 (308.66) dB in the PRP group (p=0.02).
CONCLUSIONS: In patients with sNPDR, PPV and PRP showed no significant difference in PDR progression during the 12-month follow-up, whereas the PPV group preserved better peripheral visual function.
TRIAL REGISTRATION NUMBER: NCT04103671.
METHODS: 55 eyes of 55 diabetic patients aged >18 years with sNPDR were randomised 1:1 to the PPV group (n=27) or the PRP group (n=28). Standard 25G PPV was performed by an experienced surgeon within 4 weeks of enrolment. Standard PRP was performed in three sessions within 4 weeks of enrolment. The primary outcome was the proportion of eyes progressed from sNPDR to proliferative diabetic retinopathy (PDR) over 12 months.
RESULTS: A total of 27 participants (mean (SD) age, 61.19 (8.89) years; 16 male (59.3%)) in the PPV group and 28 participants (mean (SD) age, 60.50 (7.93) years; 11 male (39.3%)) in the PRP group were analysed. At 12 months, no patients in the PPV group progressed to PDR, compared with 2 of 28 patients (7.1%) in the PRP group (p=0.49). The mean (SD) change in total visual field point score was -16.70 (415.23) dB in the PPV group and -314.00 (404.59) dB in the PRP group (p=0.02). For the peripheral 60-4 test, the mean (SD) change was -11.39 (167.99) dB in the PPV group versus -207.05 (308.66) dB in the PRP group (p=0.02).
CONCLUSIONS: In patients with sNPDR, PPV and PRP showed no significant difference in PDR progression during the 12-month follow-up, whereas the PPV group preserved better peripheral visual function.
TRIAL REGISTRATION NUMBER: NCT04103671.