scholarly journals The Role of Angiogenesis in the Development of Proliferative Diabetic Retinopathy: Impact of Intravitreal Anti-VEGF Treatment

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Gemma Tremolada ◽  
Claudia Del Turco ◽  
Rosangela Lattanzio ◽  
Silvia Maestroni ◽  
Anna Maestroni ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Blood Vessels ◽  
Laser Treatment ◽  
Proliferative Diabetic Retinopathy ◽  
Laser Photocoagulation ◽  
Antiangiogenic Treatment ◽  
Future Role ◽  
Therapeutic Protocol ◽  
Molecular Bases

Although cellular and molecular bases of proliferative diabetic retinopathy are only partially understood, it is evident that this complication of diabetes is characterized by the formation of new vessels inside the retina showing abnormal architecture and permeability. This process, if not controlled by selective laser photocoagulation, leads to irreversible retinal damages and loss of vision. Angiogenesis, that is, the condition characterized by the growth of new blood vessels originated from preexisting ones, was shown to have a major role in the pathogenesis of proliferative retinopathy and, as a consequence, intravitreal antiangiogenic injection was suggested as a feasible treatment for this disease. Here, we describe the different antiangiogenic approaches used to treat this disease along with the respective advantages and limitations when compared to laser treatment. Altogether, even though further and longer studies are still needed to clarify the best possible therapeutic protocol, the antiangiogenic treatment will reasonably have a future role in the therapy and prevention of proliferative diabetic retinopathy.

Bevacizumab-Augmented Retinal Laser Photocoagulation in Proliferative Diabetic Retinopathy: A Randomized Double-Masked Clinical Trial

2008 ◽  
Vol 18 (2) ◽  
pp. 263-269 ◽  
Author(s):  
A. Mirshahi ◽  
R. Roohipoor ◽  
A. Lashay ◽  
S.-F. Mohammadi ◽  
A. Abdoallahi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Diabetic Retinopathy ◽  
High Risk ◽  
Laser Treatment ◽  
Proliferative Diabetic Retinopathy ◽  
Laser Photocoagulation ◽  
Intravitreal Bevacizumab ◽  
Complete Regression ◽  
Standard Laser ◽  
Risk Characteristic

Purpose To evaluate the additional therapeutic effect of single intravitreal bevacizumab injection on standard laser treatment in the management of proliferative diabetic retinopathy. Methods A prospective, fellow-eye sham controlled clinical trial was conducted on 80 eyes of 40 high-risk characteristic proliferative diabetic retinopathy type II diabetics. All cases received standard laser treatment according to Early Treatment Diabetic Retinopathy Study protocol. Avastin-assigned eyes received 1.25 mg intravitreal bevacizumab (Genentech Inc., San Francisco, CA) on the first session of their laser treatments. Fluorescein angiography was performed at baseline and at weeks 6 and 16, and proliferative diabetic retinopathy regression was evaluated in a masked fashion. Results The median age was 52 years (range: 39–68) and 30% of the participants were male. All patients were followed for 16 weeks. A total of 87.5% of Avastin-injected eyes and 25% of sham group showed complete regression at week 6 of follow-up (pp<0.005). However, at week 16, PDR recurred in a sizable number of the Avastin-treated eyes, and the complete regression rate in the two groups became identical (25%; p=1.000); partial regression rates were 70% vs 65%. In the subgroup of Avastin-treated eyes, multivariate analysis identified hemoglobin A1c as the strongest predictor of proliferative diabetic retinopathy recurrence (p=0.033). Conclusions Intravitreal bevacizumab remarkably augmented the short-term response to scatter panretinal laser photocoagulation in high-risk characteristic proliferative diabetic retinopathy but the effect was short-lived, as many of the eyes showed rapid recurrence. Alternative dosing (multiple and/or periodic intravitreal Avastin injections) is recommended for further evaluation.

A Clinical Study of Diabetic Retinopathy

2003 ◽  
Vol 42 (148) ◽  
Author(s):  
KJD Karki
Keyword(s):  
Diabetic Retinopathy ◽  
Clinical Study ◽  
High Risk ◽  
Key Words ◽  
Laser Treatment ◽  
Proliferative Diabetic Retinopathy ◽  
Laser Photocoagulation ◽  
Visual Loss ◽  
Diabetic Patients ◽  
Vitrectomy Surgery

A clinical study of diabetic retinopathy was conducted from March- May 2002 to diagnose a patient’sdiabetic retinopathy level and identify eyes of proliferative diabetic retinopathy and maculopathy so thatthese patients could get appropriate and timely laser photocoagulation surgery and other surgical modalitiesto reduce the risk of visual loss. This study shows that out of 248 diabetic patients examined, 45.9% patientshad retinal changes. The potential candidates for panretinal and focal laser treatment were the patientswith very severe non-proliferative diabetic retinopathy (NPDR) (3.5%), early proliferative diabeticretinopathy (PDR) or high-risk PDR (3.5%), and maculopathy (8.8%).Key Words: Diabetic retinopathy, Laser photocoagulation surgery and vitrectomy Surgery.

Statin reduces the incidence of diabetic retinopathy and its need for intervention: A systematic review and meta-analysis

2020 ◽  
pp. 112067212092244 ◽  
Author(s):  
Raymond Pranata ◽  
Rachel Vania ◽  
Andi Arus Victor
Keyword(s):  
Diabetic Retinopathy ◽  
Intravitreal Injection ◽  
Laser Treatment ◽  
Proliferative Diabetic Retinopathy ◽  
Literature Search ◽  
Meta Analysis ◽  
Hazard Ratio ◽  
Systematic Literature Search ◽  
Comprehensive Search

Purpose: We aimed to perform a systematic literature search on the latest evidence of the role of statin in reducing diabetic retinopathy and its need for intervention. Methods: A comprehensive search on cohort studies/clinical trials that assess statins and diabetic retinopathy up until August 2019 was performed. The outcome measured was the incidence of diabetic retinopathy and its need for intervention. Results: There were 558.177 patients from six studies. Statin was associated with a lower incidence of diabetic retinopathy (hazard ratio: 0.68 (0.55, 0.84), p < 0.001; I2: 95%). For the subtypes of diabetic retinopathy, statin lowers the incidence of proliferative diabetic retinopathy (hazard ratio: 0.69 (0.51, 0.93), p = 0.01; I2: 90%), non-proliferative diabetic retinopathy (hazard ratio: 0.80 (0.66, 0.96), p = 0.02; I2: 93%), and diabetic macular edema (hazard ratio: 0.56 (0.39, 0.80), p = 0.002; I2: 82%). Statin was associated with a reduced need for retinal laser treatment with a hazard ratio of 0.70 (0.64, 0.76) (p < 0.001; I2: 0%), intravitreal injection with a hazard ratio of 0.82 (0.79, 0.85) (p < 0.001; I2: 0%), and vitrectomy with a hazard ratio of 0.64 (0.48, 0.85) (p < 0.001; I2: 75%). Overall, statin was associated with a reduced need for intervention for diabetic retinopathy with a hazard ratio of 0.72 (0.64, 0.80) (p < 0.001; I2: 73%). The regression-based Egger’s test showed statistically significant small-study effects for non-proliferative diabetic retinopathy (p = 0.011) outcomes. Conclusion: Statin was associated with a decreased risk of diabetic retinopathy and its subtypes. Statin also reduced the need for intervention with retinal laser treatment, intravitreal injection, and vitrectomy.

The Level of Cytokines in the Vitreous Body of Severe Proliferative Diabetic Retinopathy Patients Undergoing Posterior Vitrectomy

2018 ◽  
Vol 24 (27) ◽  
pp. 3276-3281 ◽  
Author(s):  
Dorota Raczyńska ◽  
Katarzyna A. Lisowska ◽  
Krzysztof Pietruczuk ◽  
Joanna Borucka ◽  
Mateusz Ślizień ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Body ◽  
Control Group ◽  
Slit Lamp ◽  
Corrected Visual Acuity ◽  
Cytokine Levels ◽  
Pars Plana ◽  
Eye Examination

Objective: The objective of the study was to compare cytokine levels in the vitreous body of patients with proliferative diabetic retinopathy (PDR) undergoing posterior vitrectomy. Patients and methods: The study included 39 patients (39 eyes) undergoing pars plana vitrectomy (PPV). Patients were divided into three groups: patients with proliferative diabetic retinopathy (PDR) without aflibercept injection prior to the surgery, PDR patients administered aflibercept injection prior to the surgery, and patients without diabetes mellitus (control group). All patients underwent a comprehensive eye examination one day before and 3 weeks after the surgery, including measurements of: best-corrected visual acuity (BVCA) and intraocular pressure (IOP), slit-lamp examination and spectral domain optical coherence tomography (SOCT). Concentrations of cytokines: IL-6, IL-8, IL-12p70, TNF, IL-10, IL-1β were measured in the vitreous body of patients with BD™ Cytometric Bead Array (CBA) Human Inflammatory Cytokines Kit. Results: PDR patients who received pretreatment with aflibercept injection showed significantly lower concentrations of IL-12p70, TNF, IL-10 and IL-1β in the vitreous body compared to the control group. Meanwhile, patients without prior aflibercept injection had a significantly higher concentration of IL-8. There was also a significant positive correlation between IOP before PPV and IL-8 concentration in both PDR patients’ groups. Conclusion: Findings of our study suggest an important role of IL-8 in the development of severe PDR. Aflibercept administration on the day before elective vitrectomy facilitated the surgery.

Novel role of erythropoietin in proliferative diabetic retinopathy

2007 ◽  
Vol 77 (3) ◽  
pp. S62-S64 ◽  
Author(s):  
Hitoshi Takagi ◽  
Daisuke Watanabe ◽  
Kiyoshi Suzuma ◽  
Masafumi Kurimoto ◽  
Izumi Suzuma ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy

scholarly journals Diabetic Retinopathy Treated with Laser Photocoagulation and the Indirect Effect on Glycaemic Control

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Anna Praidou ◽  
Sofia Androudi ◽  
Periklis Brazitikos ◽  
George Karakiulakis ◽  
Eleni Papakonstantinou ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Glycaemic Control ◽  
Laser Treatment ◽  
Laser Photocoagulation ◽  
Argon Laser ◽  
Previous Treatment ◽  
Blood Levels ◽  
Patients With Diabetes ◽  
Group A ◽  
Group B

Purpose. To identify any possible relation between glycaemic control and previous laser photocoagulation for diabetic retinopathy.Methods. Seventy-two patients with diabetes were included in the study and were separated into 2 groups according to previous treatment (group A) or not (group B) with argon laser photocoagulation. Glycaemic control was estimated by measuring blood levels of HbA1c in four consecutive measurements.Results. Blood levels of HbA1c in group A were significantly lower 3, 6, and 12 months after laser treatment as compared to blood levels of HbA1c before laser treatment (7.1±0.4% versus7.6±0.9%,7.2±0.2% versus7.6±0.9%, and7.1±0.2% versus7.6±0.9%, resp., allP<0.05). Blood levels of HbA1c in group B did not differ significantly in four consecutive measurements.Conclusion. Our results suggest that we should anticipate a better glycaemic control in cases of patients with diabetes previously treated with laser photocoagulation.

scholarly journals Treatment of cystoid macular edema in a patient with primary open angle glaucoma and diabetic retinopathy by withdrawal of travoprost

2021 ◽  
Vol 7 (2) ◽  
pp. 180-183
Author(s):  
Shiv Sagar N ◽  
BN Kalpana ◽  
Shilpa YD
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Laser Treatment ◽  
Proliferative Diabetic Retinopathy ◽  
Cystoid Macular Edema ◽  
Open Angle Glaucoma ◽  
Eye Drops ◽  
Antiglaucoma Medication ◽  
Micropulse Laser

To study the association of cystoid macular edema (CME) and Travoprost eye drops in a patient with diabetic retinopathy (DR).The study was carried out on a 65yr old patient on a regular follow up from 2009-2018.A 65yr old patient of a DR of both eyes who had received 3 sittings of pan retinal photocoagulation (PRP) laser in both eyes and grid laser to his right eye. He was on regular follow up since 2009 with a stable proliferative diabetic retinopathy (PDR). Patient was also on topical antiglaucoma medication and had prophylactic YAG-PI done both eyes. He was on regular follow up since 2009 with a stable proliferative diabetic retinopathy (PDR). Right eye showed macular edema (ME) in 2014 and underwent OCT and FFA. Patient refused for intravitreal injection and preferred laser treatment, so patient underwent micropulse laser treatment in 2014. His edema persisted even after micropulse treatment. His systemic control was good and patient continued to use Travoprost eye drops. So in 2017 suspected CME secondary to topical prostaglandin (PG) analogue as he had strict glycemic control and was no fluctuation in ME. Hence topical PG analogue was withdrawn and stopped. On subsequent follow up after 2 months CME had completely disappeared and the foveal contour returned to normal on OCT. LE was status quo. Patient was followed up for more than 1 year and continuously followed up, 15 days back in June 2018 had no evidence of CME and vision was 6/9 in both eyes.: Differentiation of DME and CME secondary to PG analogue should be made at the earliest.

scholarly journals The Role of Hypertension and Dyslipidaemia in the Progression of Diabetic Retinopathy in Type 2 Diabetes

2019 ◽  
Vol 4 (4) ◽  
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Laser Photocoagulation ◽  
Vitreoretinal Surgery ◽  
Additional Burden

Despite the introduction of retinal laser photocoagulation and vitreoretinal surgery, diabetic retinopathy (DR) remains a significant source of sight disorders and blindness amongst individuals with Type 2 Diabetes Mellitus (T2DM) [1]. Visual impairment and blindness can add an additional burden to individuals with T2DM, thereby, affecting their quality of life and ability to self-manage their diabetes [2]. The number of people registered blind and those with moderate to severe sight complications due to DR rose from 0.2 million to 0.4 and 1.4 million to 2.6 million respectively between 1990 to 2015 [3].

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