Objective: To investigate the efficacy of laser photocoagulation combined with ranibizumab in patients with diabetic retinopathy and their effect on VEGF.
Methods: The medical records of 98 patients with diabetic retinopathy treated in the First People's Hospital of Linping District from February 2020 to January 2022 were collected for a retrospective analysis. Among them, 48 patients treated with laser photocoagulation were a control group (CG), and another 50 treated with laser photocoagulation combined with ranibizumab were an observation group (OG). The treatment efficacy, best corrected visual acuity (BCVA), central macular concave thickness (CMT), and change in neovascularization area were compared between the two groups. Also, the changes in serum vascular endothelial growth factor (VEGF), homocysteine (HCY), vitamin B12 and folic acid were compared. The adverse effects that occurred with treatment were assessed. The relationship of pre-treatment BCVA, CMT, neovascularization area and VEGF levels with clinical outcomes were observed, and their predictive values were analyzed by receiver operating characteristic (ROC) curve.
Results: The total response rate of patients in the CG was lower than that in the OG (P<0.05). The BCVA, CMT, and neovascularization area were dramatically lower, while vitamin B12 and folic acid were markedly higher in the OG than in the CG after treatment (P<0.05). There was no statistical difference in adverse reactions between the two groups (P>0.05). In patients with effective response, the BCVA, CMT, VEGF and Hcy before treatment were dramatically lower than in those with ineffective response (P<0.05), while the neovascularization area, vitamin B12, and folic acid did not differ between them before treatment (P>0.05). ROC curve analysis revealed that the areas under the curve of BCVA, CMT, VEGF and Hcy were all greater than 0.7 for predicting patient outcomes, and the area under the curve of the combination of the above indexes was 0.945, with a specificity of 92.30% and sensitivity of 88.23%.
Conclusion: Laser photocoagulation combined with ranibizumab may provide good therapeutic efficacy in diabetic retinopathy, by effectively improving neovascularization and reducing VEGF levels to control further progression of the lesions.
Keywords: Laser photocoagulation; VEGF; diabetic retinopathy; ranibizumab.
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