To investigate the clinical efficacy of combining Zhixue Mingmu Formula (止血明目方) with Conbercept Ophthalmic Injection and Calcium Dobesilate Capsules in treating the patients with stage V diabetic retinopathy (DR) accompanied by vitreous hemorrhage (VH).

From January 2022 to December 2024, 100 early-stage patients diagnosed with stage V DR and VH at Hebei Provincial Eye Hospital were recruited. They were randomly divided into the observation group and the control group (50 patients in each). The control group received Conbercept Ophthalmic Injection and Calcium Dobesilate Capsules, while the observation group additionally received Zhixue Mingmu Formula. All patients adhered to a low-salt, low-fat diabetic diet, engaged in moderate exercise, and maintained conventional hypoglycemic therapy. The treatment duration was 8 weeks. Relevant clinical parameters were recorded before and after treatment to evaluate the clinical effects of these two therapeutic regimens. The therapeutic effects, TCM syndrome scores, best-corrected visual acuity, intraocular pressure, vitreous hemorrhage absorption, fundus examination findings and changes in serum levels of hypoxia-inducible factor-1 (HIF-1) and vascular endothelial growth factor (VEGF) between the two groups were compared.

The total effective rate of the observation group was 94.0% (47/50), which was much higher than 78.0% (39/50) of the control group, and the difference between the groups was significant (P<0.05). After treatment, the observation group showed better scores in TCM symptoms, decreased intraocular pressure, best corrected visual acuity of the affected eye, and better absorption of vitreous hemorrhage compared to the control group (P<0.05). After treatment, the observation group had lower visual field gray values, vascular tumors, bleeding spots and macular thickness than the control group (P<0.05). After treatment, the levels of HIF-1 and VEGF in both groups decreased, and the levels of these indicators in the observation group were lower than those in the control group (P<0.05).

The combination regimen of Zhixue Mingmu Formula with anti-VEGF therapy effectively promotes visual rehabilitation and vitreous hemorrhage resolution, maintains the stability of intraocular pressure and downregulates the levels of HIF-1α and VEGF in the stage V DR patients.