scholarly journals Intravitreal bevacizumab for proliferative diabetic retinopathy with new dense vitreous hemorrhage after full panretinal photocoagulation

Eye ◽  
2013 ◽  
Vol 27 (12) ◽  
pp. 1391-1396 ◽  
Author(s):  
S Sinawat ◽  
T Rattanapakorn ◽  
T Sanguansak ◽  
Y Yospaiboon ◽  
S Sinawat
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Intravitreal Bevacizumab ◽  
Vitreous Hemorrhage ◽  
Panretinal Photocoagulation

scholarly journals Comparison of Visual Outcomes between Panretinal Photocoagulation and Panretinal Photocoagulation Plus Intravitreal Bevacizumab in Proliferative Diabetic Retinopathy Patients Treated at Northen Zonal Hospital

2020 ◽  
pp. 34-43
Author(s):  
Filemon Darabe ◽  
William Makupa
Keyword(s):  
Diabetic Retinopathy ◽  
Retinal Detachment ◽  
Proliferative Diabetic Retinopathy ◽  
Intravitreal Bevacizumab ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Panretinal Photocoagulation ◽  
Pan Retinal Photocoagulation ◽  
The Mean ◽  
Retinal Photocoagulation

Introduction: Diabetic retinopathy is one of the rigorous microvascular complications of diabetes mellitus is the significant cause of visual impairment and consequently blindness affecting about 36% of the diabetic population. Diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) are two prime manifestations of DR that are responsible for visual morbidity. The basis of the treatment in PDR is Laser photocoagulation as accomplished by Diabetic retinopathy treatment study (DRS) and early treatment diabetic retinopathy study (ETDRS) for the last two decades. The dawn of intravitreal anti-VEGF agents has revolutionized the management of diabetic eye disease for more than the last decade. The aim of the study is to compare the visual outcomes of diabetic retinopathy patients between pan-retinal photocoagulation and pan-retinal photocoagulation plus intravitreal Bevacizumab. Methodology: A hospital-based cross-section study using medical record information for all DR patients treated by PRP and IVB at the KCMC eye. Data were analyzed using SPSS version 20. Results: A number of 204 patients were included in the study. The mean age was 59.26 (SD=9.6) years; 75.4% were male. Most of the patients 71.1% are from Arusha and Kilimanjaro. Among all, 51% had PRP alone and the duration of Diabetes was 5-10 years in the majority. The mean VA for PRP alone was 0.89 (SD=0.89) before treatment while it was 1 (SD=0.99) in PRP plus Bevacizumab. At 3 months after treatment VA for PRP alone was 0.947 (SD=0.93) and 0.96 (SD=1.01) for PRP plus Bevacizumab. The mean difference was not statistically significant. VA improved by 49% and it deteriorated by 27.7%. The majority had early proliferated DR 49.7%, 42.8% high risk proliferated DR and advanced proliferated DR was 7.5%. The complications were found in 5.6% and they included: vitreous hemorrhage (4.6%) and retinal detachment (1%) in PRP plus Bevacizumab and none in PRP alone. Conclusion: With respect to this study there is no significant difference in visual outcome for PRP alone and PRP plus injection Bevacizumab, though PRP plus Bevacizumab in treatment of DR had better visual outcome over PRP alone. PRP plus injection Bevacizumab is associated with a higher and early rate of regression of active NVs than PRP alone in patients with PDR. Further studies will be needed to determine whether IVB plus PRP is a satisfactory treatment for the prevention of vision-threatening complications such as vitreous hemorrhage and tractional retinal detachment.

Endolaserless Vitrectomy With Intravitreal Aflibercept Injection for Proliferative Diabetic Retinopathy-Related Vitreous Hemorrhage (LASER LESS TRIAL)

2018 ◽  
Vol 2 (3) ◽  
pp. 127-137
Author(s):  
Dennis M. Marcus ◽  
Harinderjit Singh ◽  
Davis C. Starnes ◽  
Harveen Walia ◽  
Amina Farooq ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Panretinal Photocoagulation ◽  
Short Term ◽  
Safety And Efficacy ◽  
Intravitreal Aflibercept ◽  
Central Subfield Thickness ◽  
Endothelial Growth Factor

Purpose: For proliferative diabetic retinopathy (PDR) eyes not requiring vitrectomy, Diabetic Retinopathy Clinical Research Protocol S and the CLARITY trial demonstrated better visual function and anatomical outcomes with less proliferative and diabetic macular edema consequences in the antivascular endothelial growth factor groups compared to the panretinal photocoagulation groups. Intravitreal aflibercept injection (IAI) may represent a useful therapy with vitrectomy for PDR-related vitreous hemorrhage (VH) as a viable alternative to intraoperative endolaser during vitrectomy. We will determine the safety and efficacy when aflibercept is used for PDR-related VH with endolaserless vitrectomy. Methods: Evaluation of endolaserless vitrectomy and 2 mg IAI for PDR-related VH. Eyes receive 1 preoperative and intraoperative IAI followed by randomization to a q8week group receiving 4 postoperative q4week IAI followed by q8week IAI or q16week group receiving 2 postoperative q4week IAI followed by q16week IAI. Main Outcome Measures: Herein, we present pooled safety and efficacy outcomes through 4 months. Results: Twenty-one of 24 eyes were randomized. Preoperative average visual acuity (VA) was 36 letters (20/200). At 4-month follow-up, 18 of 21 randomized eyes showed an average VA of 72 letters (20/40) with an average visual gain of 38 (range, 0-84 gain) letters. Average optical coherence tomography (OCT) central subfield thickness (CST) at 1-month postoperative follow-up was 311 µm. Average OCT CST at 4-month follow-up was 272 µm (average thinning of 38 µm). No significant short-term ocular or systemic adverse events were observed through 4 months. Conclusions: Endolaserless vitrectomy with IAI for PDR-related VH demonstrates short-term safety with significant VA improvement.

scholarly journals Risk Factors of Neovascular Glaucoma After 25-gauge Vitrectomy for Proliferative Diabetic Retinopathy with Vitreous Hemorrhage: A Retrospective Multicenter Study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Kei Takayama ◽  
Hideaki Someya ◽  
Hiroshi Yokoyama ◽  
Yoshihiro Takamura ◽  
Masakazu Morioka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Multicenter Study ◽  
Vitreous Hemorrhage ◽  
Neovascular Glaucoma ◽  
Panretinal Photocoagulation ◽  
Uncontrolled Diabetes ◽  
Surgical Options ◽  
25 Gauge Vitrectomy

Abstract Neovascular glaucoma (NVG) is a terminal severe complication in eyes with proliferative diabetic retinopathy (PDR), and PDR eyes with vitreous hemorrhage (VH) which undergo vitrectomy may have higher risk of postoperative NVG. The incidence and the prognostic factor of postoperative NVG after 25-gauge vitrectomy with advanced surgical options remain unclear. We retrospectively reviewed medical records of 268 eyes of 268 consecutive PDR patients with VH who underwent 25-gauge vitrectomy and 12 months follow-up at seven centers. Preoperative ocular factors (visual acuity, tractional retinal detachment, panretinal photocoagulation [PRP]), demographics and clinical factors (sex, age, diabetic duration, HbA1c, hypertension, anticoagulant medication, and kidney function), surgical procedures, and postoperative complications were compared between patients who developed postoperative NVG (9.3%) and those who did not. NVG eyes was significantly younger (P = 0.026), had shorter diabetic duration (P = 0.022), higher HbA1c (P = 0.028), absence of PRP (P = 0.039) and higher frequency of postoperative VH (P = 0.0075) than non-NVG eyes. Logistic regression analysis identified postoperative VH (P = 0.014), shorter diabetic duration (P = 0.029), and no PRP (P = 0.028) as prognostic factors for postoperative NVG. This multicenter study indicates that younger age, uncontrolled diabetes, no PRP, and postoperative VH are risk factors of post-vitrectomy NVG.

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