Abstract
<jats:p>Purpose. To perform a comprehensive comparative assessment of anatomical, functional, microvascular, and angiogenic outcomes of pars plana vitrectomy performed with and without panretinal endophotocoagulation (PRP) in patients with complications of proliferative diabetic retinopathy (PDR), with particular emphasis on retinal ischemia dynamics and vascular endothelial growth factor (VEGF) levels.Methods. A total of 231 patients (231 eyes) with PDR were included. The main group (121 eyes) underwent vitrectomy without routine PRP, while the control group (110 eyes) underwent vitrectomy combined with PRP. All patients underwent best-corrected visual acuity (BCVA) assessment, intraocular pressure measurement, optical coherence tomography (OCT), optical coherence tomography angiography (OCTA, 12×12 mm), fluorescein angiography, and computer perimetry. VEGF levels in aqueous humor were analyzed in a subgroup of 80 patients (40 from each group) before vitrectomy and during subsequent phacoemulsification with intraocular lens implantation (Phaco+IOL). Follow-up duration was 12 months.Results. Both groups demonstrated significant postoperative improvement in BCVA with no statistically significant intergroup differences. OCT angiography revealed stabilization or reduction of ischemic zones in the main group and a tendency toward enlargement of ischemic areas in the control group. VEGF concentration decreased significantly after vitrectomy in both groups, with no statistically significant difference between the groups.Conclusion. Vitrectomy without routine PRP provides comparable functional outcomes and favorable stabilization of retinal ischemia and angiogenic activity. Wide-field OCT angiography and assessment of VEGF-related biomarkers provide objective information on retinal ischemia and angiogenic activity and may assist in individualized postoperative monitoring and treatment decision-making in selected patients with proliferative diabetic retinopathy.</jats:p>