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Couturier, Aude MD*; Dupas, Bénédicte MD*; Guyomard, Jean-Laurent MD; Massin, Pascale MD, PhD*

doi: 10.1097/IAE.0000000000000226
Original Study

Purpose: To evaluate the effectiveness of vitreoretinal surgery combined with antivascular endothelial growth factor therapy to treat florid diabetic retinopathy, a rare and severe form of diabetic retinopathy in young patients.

Methods: Retrospective observational case series including 61 eyes of 45 patients operated on for florid diabetic retinopathy over the past 5 years, with preoperative or intraoperative intravitreal injection of bevacizumab. Cases were classified into three stages of disease severity, according to the extension of the fibrovascular membranes. Main outcome measures were mean change in visual acuity, anatomical outcome, and surgical complications.

Results: After a mean follow-up of 20.3 months, the mean visual acuity significantly increased from +1.7 logMAR before surgery to +0.8 logMAR after surgery (P < 0.01). The visual gain was significant in Stages I and II (P < 0.05) but not significant in Stage III. A flat retina without silicone oil was achieved in 84% of eyes. Eight eyes (13%) progressed to neovascular glaucoma and/or phthisis despite repeated surgeries.

Conclusion: Vitrectomy combined with antivascular endothelial growth factor therapy allows both favorable visual and anatomical outcomes in this rapidly evolving disease. Prognosis remains poor in severe stages, suggesting that the earlier the surgery performed, the better is the visual prognosis.

The effectiveness of vitrectomy combined with antivascular endothelial growth factor was retrospectively evaluated in florid diabetic retinopathy. The mean visual acuity significantly increased after surgery, and an anatomical success was achieved in 84% of eyes. However, prognosis remained poor in severe stages; eight eyes having progressed to neovascular glaucoma or phthisis despite surgery.

*Department of Ophthalmology, APHP, University of Denis Diderot, Paris, France; and

Department of Ophthalmology, University Hospital of Rennes, Rennes, France.

Reprint requests: Pascale Massin, MD, PhD, Service d'Ophtalmologie, Hôpital Lariboisière, 2 Rue Ambroise Paré, 75475 Paris Cedex 10, France; e-mail:

Paper presented at Société Française d'Ophtalmologie, May 2012, Paris, France.

None of the authors have any financial/conflicting interests to disclose.

© 2014 by Ophthalmic Communications Society, Inc.