title: Surgical outcomes of florid diabetic retinopathy treated with antivascular endothelial growth factor.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: *Department of Ophthalmology, APHP, University of Denis Diderot, Paris, France; and †Department of Ophthalmology, University Hospital of Rennes, Rennes, France.
authors.forename: Aude
authors.initials: A
authors.lastname: Couturier
authors.forename: Bénédicte
authors.initials: B
authors.lastname: Dupas
authors.forename: Jean-Laurent
authors.initials: JL
authors.lastname: Guyomard
authors.forename: Pascale
authors.initials: P
authors.lastname: Massin
mesh_terms: D000293:Adolescent; D000328:Adult; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000068258:Bevacizumab; D001794:Blood Pressure; D003131:Combined Modality Therapy; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007431:Intraoperative Complications; D058449:Intravitreal Injections; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D055815:Young Adult
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D006442:Glycated Hemoglobin; D042461:Vascular Endothelial Growth Factor A; C467484:VEGFA protein, human; C517652:hemoglobin A1c protein, human