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 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.

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 Incidence and Risk Factors for Tractional Macular Detachment after Anti-Vascular Endothelial Growth Factor Agent Pretreatment before Vitrectomy for Complicated Proliferative Diabetic Retinopathy

2019 ◽  
Vol 8 (11) ◽  
pp. 1960
Author(s):  
Andrea Russo ◽  
Antonio Longo ◽  
Teresio Avitabile ◽  
Vincenza Bonfiglio ◽  
Matteo Fallico ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vascular Endothelial Growth Factor ◽  
Diabetic Retinopathy ◽  
Growth Factor ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Vascular Endothelial ◽  
Macular Detachment ◽  
Anti Vegf ◽  
Endothelial Growth Factor

The study’s purpose was to determine the incidence, risk factors, and outcomes of tractional macular detachment after anti-vascular endothelial growth factor (VEGF) pretreatment before vitrectomy for complicated proliferative diabetic retinopathy. Patients who underwent primary vitrectomy for complicated proliferative diabetic retinopathy, from January 2012 to 31 December 2018, were enrolled. Ophthalmic and pre-operative data were extracted from electronic record systems. All eyes with a valuable Optical Coherence Tomography (OCT)performed within 5 days before injection of anti-VEGF and on the day of vitrectomy were included. Multivariable logistic regression showed that significant risk factors for developing tractional macular detachment included days between anti-VEGF and vitrectomy (OR, 0.71 [95% CI 0.65–0.76]; p < 0.001), vitreous hemorrhage (OR, 0.23 [95% CI 0.11–0.49]; p < 0.001), and age (OR, 1.05 [95% CI 1.02–1.08]; p < 0.001). Decision-tree analysis showed that the stronger predictors of tractional macular detachment were the time between anti-VEGF injection and vitrectomy (p < 0.001). Secondary predictors were the presence of vitreous hemorrhage (p = 0.012) in eyes that underwent vitrectomy between 6 and 10 days after anti-VEGF injection and younger age (p = 0.031) in eyes that underwent vitrectomy 10 days after anti-VEGF injection. Tractional macular detachment occurs in 10% of eyes after anti-VEGF injection, the main risk factors being days between anti-VEGF injection and vitrectomy, vitreous hemorrhage, and age.

scholarly journals Comparison of outcomes between intravitreal ranibizumab and intravitreal aflibercept for diabetic macular edema with “Treat-and-Extend” regimen

2020 ◽  
Author(s):  
Masahiko Sugimoto ◽  
Shinichiro Chujo ◽  
Taku Sasaki ◽  
Atsushi Ichio ◽  
Ryohei Miyata ◽  
...  
Keyword(s):  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Retinal Thickness ◽  
Intravitreal Ranibizumab ◽  
Treat And Extend ◽  
Corrected Visual Acuity ◽  
Anti Vegf ◽  
Intravitreal Aflibercept ◽  
Treatment Naïve ◽  
Treat And Extend Regimen

Abstract Background To compare the effectiveness of intravitreal ranibizumab (IVR) and intravitreal aflibercept (IVA) performed with the Treat-and-Extend (TAE) regimen on eyes with diabetic macular edema (DME).Patients and methods This was a retrospective study of 125 eyes of 125 treatment naïve DME patients who received anti-VEGF injections at 3 consecutive monthly intervals as the loading phase. Of these 125 eyes, 26 eyes completed the treatment with the TAE regimen for at least 24 months. Among the 26 eyes, 13 eyes of 13 patients (mean age, 70.9±6.0 years) received intravitreal injections of 0.5 mg ranibizumab and 13 eyes of 13 patients (65.9±8.6 years) received 2 mg aflibercept. The changes in the best-corrected visual acuity (BCVA), central retinal thickness (CRT), diabetic retinopathy severity (DRS), and total injection numbers were compared between the two anti-VEGF agents.Results No significant differences were detected in the baseline demographics. At 24 months, the BCVA was significantly improved in both groups; from 0.31±0.19 to 0.10±0.12 logMAR units for IVR and 0.41±0.19 to 0.16±0.28 logMAR units for IVA ( P=1.29x10 -9 ). The CRT was significantly reduced in both groups; 440.9±69.3 to 307.5±66.4 μm for IVR and 473.9±71.5 to 317.8±71.2 μm for IVA ( P=3.55x10 -9 ). No significant differences were detected in the improvements of the BCVA and the CRT in both groups, and the total injection numbers were significant fewer for the IVA group (11.0±1.2) than the IVR group (12.0±1.0). The DRS was significantly improved in both groups ( P =0.0004 for IVR and P =0.009 for IVA).Conclusion No significant differences were detected in the improvements of the BCVA or CRT and injection numbers between IVR and IVA groups treated with the TAE regimen. These results indicate that the results of the treatment with both agents with the TAE regimen were equally effective.

Combination Antivascular Endothelial Growth Factor and Modified Panretinal Photocoagulation in Management of Proliferative Diabetic Retinopathy

2020 ◽  
Vol 4 (5) ◽  
pp. 401-410
Author(s):  
Amy Q. Lu ◽  
Bozho Todorich
Keyword(s):  
Diabetic Retinopathy ◽  
Growth Factor ◽  
Proliferative Diabetic Retinopathy ◽  
Case Series ◽  
Disease Suppression ◽  
Final Visit ◽  
Panretinal Photocoagulation ◽  
Anti Vegf ◽  
Antivascular Endothelial Growth Factor ◽  
Endothelial Growth Factor

Purpose: This work evaluates the effects of combined intravitreal antivascular endothelial growth factor (anti-VEGF) and modified panretinal photocoagulation (PRP) for management of proliferative diabetic retinopathy (PDR). Methods: This retrospective case series included 37 eyes of 33 patients with high-risk PDR. Anti-VEGF injections (≥ 2) were followed by modified, midperipheral PRP performed in 2 or more sessions. Visual and anatomic outcomes were tracked for 1 year after treatment. Regression analysis was performed for factors predictive of final outcomes. Results: Mean visual acuity (VA) at initial and final visit were 20/50 and 20/40 ( P = .22), respectively, over a mean follow-up duration of 341.4 days. Central foveal thickness decreased from 321.8 µm to 258.6 µm ( P = .01). Resolution of PDR was achieved in 94.6% of eyes, with 5.4% of eyes requiring additional anti-VEGF for persistent neovascularization. Final VA was significantly associated with baseline VA, VA at 1 month, and any adverse anatomical events. Treatment noncompliance was present in 24.3%; compliance decreased with increasing medical comorbidities, but was not significantly associated with final VA. Conclusions: Combination of anti-VEGF and modified PRP preserved VA and yielded PDR regression in the majority of eyes. This combination provides rapid PDR regression with anti-VEGF while achieving durable disease suppression in this real-world cohort without traditional PRP.

Results of Anti-VEGF Therapy in the Treatment of Post-vitrectomy Vitreous Hemorrhage in Patients with Proliferative Diabetic Retinopathy

2021 ◽  
pp. 97-103
Author(s):  
O. O. Putiienko
Keyword(s):  
Diabetic Retinopathy ◽  
Gas Exchange ◽  
Recurrence Rate ◽  
Proliferative Diabetic Retinopathy ◽  
Treatment Options ◽  
Vitreous Hemorrhage ◽  
Main Group ◽  
Control Group ◽  
Anti Vegf ◽  
Significant Difference

Post-vitrectomy vitreous hemorrhage in patients with proliferative diabetic retinopathy (PDR) occurs in up to 75% of cases, and this highlights the need to search for new treatment options. The aim. To analyze the results of anti-VEGF therapy in the treatment of post-vitrectomy vitreous hemorrhage in patients with PDR. Materials and methods. Seventy-eight patients (78 eyes) were examined. Twenty patients (20 eyes) of the control group underwent outpatient fluid gas exchange (OFGE) with 20% gas-air mixture of perfluoropropane for the treatment of post-vitrectomy vitreous hemorrhage. The first main group included 28 patients in whom OFGE with the same mixture was supplemented by the injection of Lucentis at a dose of 0.5 mg into the vitreous cavity. The second main group included 30 patients who achieved Eylea at a dose of 2 mg in addition to the OFGE. Results. Within 2 months, no significant difference between groups in achieving vitreous transparency or in vitreous hemorrhage recurrence rate was found. After 6 months, the frequency of vitreous hemorrhage recurrence in the control group was significantly higher (χ2 = 4.27; p = 0.039) than that in the Lucentis group (9 eyes [45%] vs. 3 eyes [10.7%]). When using Eylea in the same period, the recurrence rate was 6.7% (2 eyes) which is significantly lower than 45% (9 eyes) in the control group (χ2 = 4.59; p = 0.032). Conclusions. The effectiveness of treatment of post-vitrectomy vitreous hemorrhage by OFGE with 20% gas-air mixture of perfluoropropane within 6 months of observation is 85.5%. The use of Lucentis increases the effectiveness to 92.8% with a recurrence rate of 10.7%, and the use of Eylea to 96.6% with a recurrence rate of 6.7%. There are no significant differences between the use of Lucentis and Eylea. Keywords: proliferative diabetic retinopathy, post-vitrectomy vitreous hemorrhage, outpatient fluid gas exchange, Lucentis, Eylea.

EFFICACY OF INTRAVITREAL RANIBIZUMAB INJECTIONS IN THE TREATMENT OF VITREOUS HEMORRHAGE RELATED TO PROLIFERATIVE DIABETIC RETINOPATHY

Retina ◽  
2018 ◽  
Vol 38 (6) ◽  
pp. 1127-1133 ◽  
Author(s):  
Elias Chelala ◽  
Joseph Nehme ◽  
Hala El Rami ◽  
Roni Aoun ◽  
Ali Dirani ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Intravitreal Ranibizumab

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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