AIM:To investigate the effect of anti-VEGF combined with panretinal photocoagulation(PRP)in the treatment of severe non-proliferative diabetic retinopathy(sNPDR)with diabetic macular edema(DME)on the change of macular blood flow density.METHODS: Data of 30 eyes in 30 patients at Guangxi Zhuang Autonomous Region People's Hospital from October 2018 to April 2019 were retrospectively reviewed, and they were randomly divided into group A and group B each with 15 cases. Group A was received PRP

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... ment after one initial intravitreal ranibizumab injection followed by pro re nata(PRN)at 7d, while group B was administered PRP alone. The blood flow density of superficial capillary plexus(SCP)and deep capillary plexus(DCP)in macular area(6mm×6mm), central macular thickness(CMT), and best corrected visual acuity [BCVA(LogMAR)] were compared between the two groups before and after treatment. RESULTS: Compared with before operation, the DCP blood flow density was significantly increased, CMT was obviously decreased, and BCVA was markedly improved in group A at 2wk and 1mo after surgery(all P<0.05), while CMT was decreased and BCVA was improved in group B at 1mo after operation(all P<0.05). Postoperative in group A at 2wk and 1mo, the DCP blood flow density was significantly higher than that in group B(43.37%±2.72% vs 41.03%±2.60%, 45.01%±2.28% vs 41.20%±2.43%, P<0.05), CMT was obviously lower than group B(303.4±30.36μm vs 329.60±31.47μm, 268.67±30.27μm vs 319.40±28.63μm, all P<0.05), and BCVA(LogMAR)was markedly improved compared with group B(0.28±0.11 vs 0.40±0.13, 0.23±0.14 vs 0.38±0.15, all P<0.05).CONCLUSION: Anti-VEGF combined with PRP can effectively increase DCP blood flow density, reduce macular edema and improve visual acuity in the short term in patients with sNPDR with DME.