scholarly journals Characteristics and outcomes of vitrectomy for proliferative diabetic retinopathy in young versus senior patients

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mengyu Liao ◽  
Xiaohong Wang ◽  
Jinguo Yu ◽  
Xiangda Meng ◽  
Yuanyuan Liu ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Retinal Detachment ◽  
Patient Group ◽  
Proliferative Diabetic Retinopathy ◽  
Young Patients ◽  
Case Series ◽  
Vitreous Hemorrhage ◽  
Diabetic Patients ◽  
Case Series Study ◽  
Senior Patients

Abstract Background Proliferative diabetic retinopathy (PDR) is one of the most common cause of vision loss in diabetic patients, and the incidence age of PDR patients gradually gets younger. This study aims to compare the characteristics of PDR and outcomes following vitrectomy in young and senior patients. Methods This is a retrospective case series study. Data of 116 eyes of 92 patients who underwent vitrectomy for PDR from February 2012 to February 2017 were reviewed, which were divided into young and senior patient groups. All patients were followed up for 24 months at least. Results There were 62.1% of eyes with tractional retinal detachment secondary to PDR in the young patient group, while only 12.1% of eyes in the senior patient group with this surgery indication. (P < 0.001) The best corrected visual acuity increased in 41 eyes (70.7%), stable in 9 eyes (15.5%), and decreased in 8 eyes (13.8%) in young patients at the final follow-up. And it increased in 47 eyes (81.0%), stable in 2 eyes (3.4%), and decreased in 9 eyes (15.5%) in senior patients.(P = 0.085) Postoperative complications mainly included recurrent vitreous hemorrhage (24.1%), retinal detachment (3.4%), neovascular glaucoma (NVG) (27.6%) and nuclear sclerosis (53.4%) in young patients, and it was 19.0, 0.0, 1.7 and 3.4% in senior patients respectively. Conclusion PDR of young patients is more severe than that of senior patients, and vitrectomy is an effective and safe method for PDR treatment. NVG is a main and severe complication besides nuclear sclerosis in young patients, and the incidence of NVG is higher compared to that in senior patients.

Pars-plana-Vitrektomie bei proliferativer diabetischer Retinopathie: Unterschiede zwischen jüngeren und älteren Patienten

2021 ◽  
pp. 1-5
Author(s):  
Viktoria Mrugala ◽  
Albert J. Augustin
Keyword(s):  
Retinal Detachment ◽  
Patient Group ◽  
Vision Loss ◽  
Young Patients ◽  
Case Series ◽  
Vitreous Hemorrhage ◽  
Diabetic Patients ◽  
Case Series Study ◽  
Pars Plana Vitrektomie ◽  
Senior Patients

<b>Background:</b> Proliferative diabetic retinopathy (PDR) is one of the most common cause of vision loss in diabetic patients, and the incidence age of PDR patients gradually gets younger. This study aims to compare the characteristics of PDR and outcomes following vitrectomy in young and senior patients. <b>Methods:</b> This is a retrospective case series study. Data of 116 eyes of 92 patients who underwent vitrectomy for PDR from February 2012 to February 2017 were reviewed, which were divided into young and senior patient groups. All patients were followed up for 24 months at least. <b>Results:</b> There were 62.1% of eyes with tractional retinal detachment secondary to PDR in the young patient group, while only 12.1% of eyes in the senior patient group with this surgery indication. (<i>P</i> &#x3c; 0.001) The best corrected visual acuity increased in 41 eyes (70.7%), stable in 9 eyes (15.5%), and decreased in 8 eyes (13.8%) in young patients at the final follow-up. And it increased in 47 eyes (81.0%), stable in 2 eyes (3.4%), and decreased in 9 eyes (15.5%) in senior patients (<i>P</i> = 0.085). Postoperative complications mainly included recurrent vitreous hemorrhage (24.1%), retinal detachment (3.4%), neovascular glaucoma (NVG) (27.6%) and nuclear sclerosis (53.4%) in young patients, and it was 19.0, 0.0, 1.7 and 3.4% in senior patients respectively. <b>Summary:</b> PDR of young patients is more severe than that of senior patients, and vitrectomy is an effective and safe method for PDR treatment. NVG is a main and severe complication besides nuclear sclerosis in young patients, and the incidence of NVG is higher compared to that in senior patients.

Does Pars Plana Vitrectomy Improve Visual Outcomes in Patients with Complications of Proliferative Diabetic Retinopathy

2020 ◽  
pp. 185-190
Author(s):  
Alan D. Penman ◽  
Kimberly W. Crowder ◽  
William M. Watkins
Keyword(s):  
Clinical Trial ◽  
Diabetic Retinopathy ◽  
Retinal Detachment ◽  
Proliferative Diabetic Retinopathy ◽  
Pars Plana Vitrectomy ◽  
Vitreous Hemorrhage ◽  
Diabetic Patients ◽  
Visual Outcomes ◽  
Management Of Complications ◽  
Pars Plana

The Early Treatment Diabetic Retinopathy Study (ETDRS) was a randomized clinical trial involving nearly four thousand diabetic patients with early proliferative retinopathy, moderate to severe nonproliferative retinopathy, and/or diabetic macular edema in each eye. This paper (ETDRS report number 17) describes the baseline previtrectomy characteristics, initial treatment assignments, indications for vitrectomy, and visual outcomes in the subgroup of patients in the ETDRS who had pars plana vitrectomy (PPV). The study showed that pars plana vitrectomy could improve visual outcomes in patients with complications from proliferative diabetic retinopathy such as vitreous hemorrhage and retinal detachment. PPV continues to play an important role in the management of complications from proliferative diabetic retinopathy.

scholarly journals Anti-vegf therapy in treatment of vitreous hemorrhage due to proliferative diabetic retinopathy

2020 ◽  
Vol 13 (4) ◽  
pp. 83-88
Author(s):  
Aysylu B. Galimova ◽  
Venera U. Galimova
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Case Series ◽  
Vitreous Hemorrhage ◽  
Intravitreal Ranibizumab ◽  
Treat And Extend ◽  
Anti Vegf ◽  
Case Series Study ◽  
Vitreoretinal Traction ◽  
Treat And Extend Regimen

Purpose.To investigate the possibility of anti-VEGF therapy use in treatment of vitreous hemorrhage due to proliferative diabetic retinopathy without signs of vitreoretinal traction. Materials and methods.In this case series study, 8 patients with severe vitreous hemorrhage due to proliferative diabetic retinopathy without signs of vitreoretinal traction were treated with intravitreal ranibizumab injections using treat-and-extend regimen. Patients were followed for 1254 months. Results.. Intravitreal ranibizumab injections using treat-and-extend regimen promoted a complete resolution of vitreous hemorrhage in one month after the 2ndor the 3rdmonthly ranibizumab injection, followed by a significant visual acuity improvement. Conclusion.Anti-VEGF therapy using treat-and-extend regimen could be recommended for treatment of vitreous hemorrhage due to proliferative diabetic retinopathy without signs of vitreoretinal traction.

scholarly journals Ghost cell glaucoma after intravitreous injection of ranibizumab in proliferative diabetic retinopathy

2019 ◽  
Author(s):  
Jun XU ◽  
Meng ZHAO ◽  
Jipeng LI ◽  
Ningpu LIU
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Case Series ◽  
Vitreous Hemorrhage ◽  
Stepwise Logistic Regression ◽  
Ghost Cell ◽  
Retrospective Case ◽  
Intravitreous Injection ◽  
Case Series Study ◽  
Potential Factors

Abstract BACKGROUND: Intravitreous injection of anti-vascular endothelial growth factor agents has been widely used as an adjunctive method to vitrectomy in eyes with vitreous hemorrhage due to proliferative diabetic retinopathy (PDR). Here we reported a series of patients with PDR who developed ghost cell glaucoma after intravitreous injection and analyzed the potential factors that might be related to the development of ghost cell glaucoma. METHODS: Retrospective case series study. A total of a consecutive 71 eyes of PDR patients who received vitrectomy after intravitreous injection of ranibizumab (IVR) from January 2015 to January 2017 were enrolled in the study.Intraocular pressure (IOP) was recorded before and after intravitreous injection. Medical records of patients were recorded and investigated. The onset and treatment of ghost-cell glaucoma were recorded. RESULTS: There were 8 out of 71 eyes of the PDR patients developed ghost cell glaucoma after they received IVR. The interval between detection of elevation of IOP and intravitreous injection ranged from 0 to 2 days. There were 2 eyes had IOP greater than 30mmHg at the first IOP measurement at 30 minutes after IVR and remained elevated thereafter. The mean maximum IOP was 46.5±8.0 mmHg. There were 5 patients required medicine and 3 patients required additional paracentesis to control IOP. All patients gained normal IOP after vitrectomy and did not require medicine for lowering IOP ever since. The binary backward stepwise logistic regression model showed that the presence of ghost cell glaucoma was associated with tractional retinal detachment (RR= 4.60 [2.02~8.48], p= 0.004) and fibromembrane involving disk (RR=-3.57 [-7.59~-0.92], p=0.03) (AIC= 39.23，AUC=0.88). CONCLUSION: The ghost cell glaucoma can occur after IVR among PDR patients who are required vitrectomy. Attention on postoperative IOP should be paid to patients with PDR undergoing vitrectomy who receive a preoperative intravitreous injection of anti-VEGF agents, especially in patients with severe PDR.

scholarly journals Systemic association of newly diagnosed proliferative diabetic retinopathy among type 2 diabetes patients presented at a tertiary eye hospital of Nepal

2015 ◽  
Vol 7 (1) ◽  
pp. 26-32
Author(s):  
R Thapa ◽  
S Bajimaya ◽  
S Sharma ◽  
B B Rai ◽  
G Paudyal
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Blood Sugar ◽  
Proliferative Diabetic Retinopathy ◽  
Poor Glycemic Control ◽  
Diabetic Patients ◽  
Newly Diagnosed ◽  
Duration Of Diabetes ◽  
Case Series Study

Introduction: Proliferative diabetic retinopathy (PDR) is the leading cause of blindness among the diabetics. Objective: to study the systemic association of proliferative diabetic retinopathy. Materials and methods: A prospective, case-series study was conducted among the newly diagnosed proliferative diabetic retinopathy cases presenting at the Tilganga Institute of Ophthalmology (TIO) from January 2012 to January 2013. Diabetic retinopathy was classi¿ed using the Early Treatment Diabetic Retinopathy Study criteria. Blood pressure, fasting and postprandial blood sugar, glycosylated hemoglobin, lipid pro¿le, urine for microalbumin, urea, and creatinine were evaluated at the time of diagnosis.Results: A total of 104 type 2 diabetic patients with newly diagnosed PDR presented during the study period. Concurrent macular edema was present in 93 cases (89.42 %). The mean age was 56.96 ± 9.394 (range 32 - 78) years. Males and females comprised of 75.7 % and 24.3 % respectively. The majority (37.5 %) were involved in business, followed by government service (17.30 %), and housewives (16.34 %). Mean duration of diabetes was 11.42 ± 5.356 years (range 1 month - 26 years). Concurrent hypertension was found in 55.76 %, uncontrolled fasting and or postprandial blood sugar in 72.54 %, poor glycemic control (HbA1C > 7 %) in 73.97 %, abnormal lipid profile in 52.56 %, microalbuminuria in 67.85 %, and positive urine albumin in 50 % of the cases.Conclusion: Despite the short duration of diabetes, the concurrent hypertension, poor glycemic control, proteinuria and dyslipidemia were the main systemic associations for PDR at our clinical set-up. Awareness, identification and management of these systemic problems could reduce the rapid progression to PDR.

scholarly journals Prevalence, risk factors and awareness of diabetic retinopathy among admitted diabetic patients at a tertiary level hospital in Kathmandu

2014 ◽  
Vol 6 (1) ◽  
pp. 24-30 ◽  
Author(s):  
Raba Thapa ◽  
Deepak Man Joshi ◽  
Aparna Rizyal ◽  
Nhukesh Maharjan ◽  
Rajesh Dhoj Joshi
Keyword(s):  
Risk Factors ◽  
Diabetic Retinopathy ◽  
Case Series ◽  
Systemic Hypertension ◽  
P Value ◽  
Diabetic Patients ◽  
Duration Of Diabetes ◽  
Case Series Study ◽  
Systemic Problems ◽  
Clinically Significant

Introduction: Diabetic retinopathy (DR) is one of the commonest causes of visual impairment and blindness in Nepal. Objectives: The study aims to explore the prevalence, risk factors and awareness of DR among admitted diabetic patients. Materials and methods: A non-interventional case series study was conducted among the inpatient diabetic cases referred for ophthalmic consultation. The patients’ detailed demographics, awareness on DR, concurrent systemic problems, and glycemic control status were recorded. DR was graded using the Early Treatment Diabetic Retinopathy Study Criteria. Main outcome measures: The prevalence, risk factors and awareness of diabetic retinopathy among the study participants was analyzed. Results: A total of 277 diabetic patients were enrolled in the study. The mean age was 62.25 ± 13.26 years. Only one-third (34.6 %) of the cases were admitted for sugar control and newly diagnosed cases comprised of 19.49 %. Nearly half of the cases (46.6 %) were not aware of diabetic retinopathy and dilated fundus evaluation was done for the first time in 44.4 %. DR was found in 38.26 % of the cases and was diagnosed in 13 % of the new cases. Almost four-fifths (78 %) of the diabetics had had the disease for a duration of 16 to 20 years. Clinically significant macular edema was found in 5.78 % and proliferative DR in 2.52 %. DR was significantly associated with the duration of diabetes (P value = 0.001) and concurrent hypertension (P value = 0.004). Conclusion: The prevalence of DR was 38 % among the admitted diabetic cases and the DR was significantly associated with the duration of diabetes and systemic hypertension. Almost half of the cases had been unaware of DR before referral. This emphasizes the importance of the collaboration of the physician and the ophthalmologist for an early DR detection.   DOI: http://dx.doi.org/10.3126/nepjoph.v6i1.10760   Nepal J Ophthalmol 2014; 6 (2): 24-30

scholarly journals Relationship between HbA1c Levels and Severity of Diabetic Retinopathy

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Saima Jamshed ◽  
Ayesha Hanif ◽  
Irfan Qayyum Malik ◽  
Nukhba Zahid ◽  
Hafiza Sadia Imtiaz
Keyword(s):  
Diabetic Retinopathy ◽  
Glycemic Control ◽  
Proliferative Diabetic Retinopathy ◽  
Hba1c Level ◽  
Vitreous Hemorrhage ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Grade 5

Purpose:  To determine the relationship between HbA1c and severity of retinopathy in diabetic patients. Study Design:  Cross sectional study. Place and Duration of Study:  Eye department of DHQ-UTH Gujranwala, from July 2020 to Dec 2020. Methods:  An observational cross-sectional study including 100 patients was conducted at eye department of DHQ-UTH Gujranwala from January 2018 to December 2018. After approval from institutional review board, written informed consent with demographic variables was collected from every patient. Patients of either gender between 40-80 years of age with both types I and type II diabetes were included in this study. Complete ophthalmic examination including Best Corrected Visual Acuity, slit lamp biomicroscopy, Goldmann Applanation tonometry and fundus examination carried out. Diabetic retinopathy was classified from grade 0 to grade 5. Results:  Out of 100 patients, 46 (46%) were males and 54 (54%) were females. Mean age was 60 ± 2.4 years with a range of 40 – 80 years among males and 40 – 70 years among females. Forty patients presented with grade 1 diabetic retinopathy and 4% presented with grade 5. Thirty two patients had good glycemic control while 20% had glycemic control of grade III. Patients with grade 4 diabetic retinopathy had the worst glycemic control of HbA1c level of 11.5. Conclusion:  This study concluded that patients with poor glycemic control had severe diabetic retinopathy as compared to the patients with good diabetic control. There is a direct relation between HbA1c level and severity of diabetic retinopathy. Key Words:  HbA1C, Diabetic retinopathy, Non proliferative diabetic retinopathy, Proliferative diabetic retinopathy, Vitreous hemorrhage.

scholarly journals Variable presentation of diabetic papillopathy and treatment dilemma- A case series

2020 ◽  
Vol 12 (2) ◽  
pp. 328-332
Author(s):  
Archana Kumari ◽  
Lalit Agarwal ◽  
Nisha Agrawal ◽  
Indranath Prasad ◽  
Kshitij Aditya ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Wide Spectrum ◽  
Young Patients ◽  
Case Series ◽  
Type1 Diabetes ◽  
Type 2 Diabetics ◽  
Variable Presentation

Introduction: Diabetic papillopathy (DP) is a diagnosis of exclusion in type 1 and type 2 diabetics with transient disc edema. It was initially described in young patients with type1 diabetes mellitus (DM) as a bilateral disease with minimal visual symptoms which resolved spontaneously. Lately, DP has been a focus of controversy because of its wide clinical spectrum. Cases: We describe three variable cases of DP. These are unilateral DP with Proliferative Diabetic Retinopathy (PDR) with macular edema (ME), unilateral DP with severe Non Proliferative Diabetic Retinopathy (NPDR) with ischemic maculopathy and a case of bilateral DP with Moderate NPDR with ME. We also discuss viable treatment for the variable presentation. DP has been reported in this case series in moderate NPDR, severe NPDR as well as PDR. Macular involvement in the form of macular edema as well as ischemia has been demonstrated to result in diminution of vision. It shows both unilateral and bilateral presentation. Remarkable visual loss seen, in these cases, call for intervention. Conclusions: DP has a wide spectrum of presentation and its knowledge is eminent to make a complete diagnosis. Individualisation of treatment has to be done for variable presentation and realistic outcomes should be explained to the patients.

scholarly journals Role of Panretinal Photocoagulation in Improvement of Visual Acuity of Patients with Proliferative Diabetic Retinopathy

2021 ◽  
pp. 211-217
Author(s):  
Shabeer Ahmed Bhutto ◽  
Zakaullah Gopang ◽  
Safder Ali Abbasi ◽  
Naeem Akhtar Katpar ◽  
Muhammad Yusuf Depar ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Case Series ◽  
Panretinal Photocoagulation ◽  
Yag Laser ◽  
Case Series Study ◽  
Medical University ◽  
Series Study

Objective: To determine the improvement of visual acuity in patients having proliferative diabetic retinopathy undergoing panretinal photocoagulation therapy. Study design: This is a descriptive case series study. Setting: Study carried out at Ophthalmology Department, ShaheedMohtarma Benazir Bhutto Medical University Larkana, from 01-10-2019 to 31-03-2020 (06 months). Materials and methods: We selected patient with proliferative diabetic retinopathy from the retina clinic after taking a careful history and clinical examination including visual acuity anterior and posterior segment examination and then patient selected for panretinal coagulation with the  help of frequency-doubled Nd: YAG laser in three or four sittings. Results: The total of 158 eyes of 110 patients with proliferative diabetic retinopathy were included in this study out of which improvement of visual acuity was found in 38 (24%) eyes and 120 (76%) eyes have no improvement or same vision. Conclusion: Proliferative Diabetic Retinopathy (PDR) can successfully be treated with panretinal coagulation with the help of frequency doubled Nd: YAG laser therapy.

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