Effect of Pars Plana Vitrectomy (PPV) on the Treatment Interval of Intravitreal Anti-Vascular Endothelial Growth Factor (Anti-VEGF) Agents

Abstract

Purpose : To assess how the removal of the vitreous humor via pars plana vitrectomy (PPV) changes the need for treatment with intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents.

Methods : Retrospective, observational case series. Inclusion criteria were a history of PPV and need for treatment with anti-VEGF agents for various indications, such as age-related macular degeneration (AMD), diabetic macular edema (DME) and retinal vein occlusion (RVO). Primary outcome was change in treatment interval with anti-VEGF, before and after PPV. Secondary outcomes were change in best-corrected visual acuity (BCVA) using Snellen and change in central retinal thickness (CRT) measured with spectral-domain optical coherence tomography (SD-OCT), before and after PPV.

Results : Seventeen eyes from 17 patients met inclusion criteria. Indications for PPV included vitreous hemorrhage, retinal detachment, epiretinal membrane, macular hole, endophthalmitis, dislocated intraocular lens, and retained lens fragment. The mean anti-VEGF treatment interval were 44.9 days before PPV and 47.4 days after PPV (p = 0.472). The mean BCVA were 20/126 before PPV and 20/408 after PPV (p > 0.05). The mean CRT were 351 μm before PPV and 315 μm after PPV (P < 0.05).

Conclusions : No significant change in anti-VEGF treatment interval was seen before and after PPV. Reduction in central retinal thickness and stabilization in visual acuity were demonstrated. Further studies are needed to provide guidance on adequate dosing regimens in vitrectomized eyes.

This is a 2020 ARVO Annual Meeting abstract.