Outcomes of anti-VEGF therapy compared with conventional interventions in diabetic retinopathy management.

The present study aimed to observe the progression of diabetic retinopathy (DR) and compare the clinical outcomes of anti-vascular endothelial growth factor (anti-VEGF) therapy, laser photocoagulation and vitrectomy in a real-world setting, to inform treatment strategies. The present prospective, observational study enrolled 371 patients (466 eyes) with DR who were followed for over 3 years at Xi'an Bright Eye Hospital (Xi'an, China). Patients received treatment with anti-VEGF, laser, combined therapy or vitrectomy based on their clinical condition. Best-corrected visual acuity (BCVA), central subfield thickness (CST) and incidence of complications were evaluated. The anti-VEGF group demonstrated a significantly greater improvement in BCVA and a reduction in CST compared with the laser group. Eyes with early-stage DR required fewer anti-VEGF injections to achieve stability than those with advanced disease. In eyes with low vision, the anti-VEGF group had a lower incidence of tractional retinal detachment but a higher rate of persistent macular edema compared with those in the laser group. For stages 4-5 DR, the rate of vision improvement was similar between anti-VEGF therapy and vitrectomy. In conclusion, anti-VEGF therapy is generally superior to laser in improving visual and anatomical outcomes. However, treatment strategies should be individualized based on disease stage and specific complications, with anti-VEGF favoring traction prevention and laser potentially offering better control for recurrent edema in some cases.