Intravitreal Ranibizumab versus Vitreous Lavage for Postoperative Vitreous Hemorrhage in Proliferative Diabetic Retinopathy: A Randomized Controlled Trial.

At 24 weeks, BCVA improvement was comparable between the VL and IVR groups.

• VL group achieved 0.30 LogMAR improvement versus 0.22 LogMAR improvement in the IVR group at 24 weeks.
• The difference was not statistically significant (p=0.47).
• Study included 26 patients: VL group n=12, IVR group n=14.
• Follow-up evaluations occurred at 1 day, 1 week, 2 weeks, and monthly for up to 6 months.

VL achieved significantly superior immediate BCVA gains at 1 day compared to IVR.

• At 1 day post-treatment, BCVA was 1.99 LogMAR in the VL group versus 0.91 LogMAR in the IVR group (p<0.01).
• Visual Acuity Recovery Rate (VARR) was significantly higher in the VL group at 1 day (0.76 vs 0.25, p<0.001).
• VARR remained numerically higher in VL at 2 weeks (0.84 vs 0.61, p=0.06) but did not reach statistical significance.
• IVR demonstrated progressive improvement beginning after 2 weeks rather than immediate gains.

Visual acuity recovery rates converged between VL and IVR groups by 24 weeks.

• VARR was comparable between groups at 24 weeks (p=0.86).
• The early advantage of VL in VARR at 1 day (p<0.001) and 2 weeks (p=0.06) was no longer present at the end of follow-up.
• IVR showed a trend towards sustained recovery over the 24-week study period.

Complication rates were similar between VL and IVR groups.

• Rates of recurrent hemorrhage and neovascular glaucoma were compared between groups.
• No statistically significant differences in complication rates were observed (p>0.05 for all comparisons).
• The adverse treatment outcomes after the two treatments did not significantly differ.

The study introduced novel metrics to quantify visual recovery dynamics in POVH.

• Three novel metrics were defined: Visual Acuity Recovery Rate (VARR), Time to 1.0 logMAR-Equivalent Improvement (T1EI), and time to peak BCVA (Tpeak VA).
• These metrics were designed to capture the dynamics of visual recovery rather than only endpoint BCVA values.
• The metrics allowed differentiation of the immediate versus progressive recovery patterns between VL and IVR.

This was a prospective randomized controlled trial comparing IVR and VL for POVH following PPV for PDR.

• 26 patients with POVH following PPV for PDR were enrolled and randomized.
• Patients were allocated to VL (n=12) or IVR (n=14) groups.
• Primary outcome measures included BCVA and complication rates over a 24-week follow-up period.
• VL mechanically clears hemorrhages while IVR targets VEGF-mediated neovascularization as the mechanistic rationale for comparison.