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 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

2020 ◽  
Author(s):  
Jun XU ◽  
Meng ZHAO ◽  
Jipeng LI ◽  
Ningpu LIU
Keyword(s):  
Logistic Regression ◽  
Retinal Detachment ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Case Series ◽  
Stepwise Logistic Regression ◽  
Ghost Cell ◽  
Tractional Retinal Detachment ◽  
Intravitreous Injection ◽  
Case Series Study

Abstract BACKGROUND: The development of ghost cell glaucoma in patients with PDR after intravitreous injection was rare. Here we reported a series of patients with PDR who received Intravitreous Ranibizumab (IVR) and developed ghost cell glaucoma and analyzed the potential factors that might be related to the development of ghost cell glaucoma.METHODS: Retrospective case series study. The medical records of 71 consecutive eyes of 68 PDR patients who received vitrectomy after IVR from January 2015 to January 2017 were reviewed. The development of ghost cell glaucoma after IVR was recorded. Characteristics of enrolled patients were retrieved from their medical charts. Factors associated with ghost cell glaucoma were compared between eyes with the development of ghost cell glaucoma and eyes without the development of ghost cell glaucoma. Variables were further enrolled in a binary backward stepwise logistic regression model, and the model that had the lowest AIC was chosen. 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 intraocular pressure ( IOP ) and intravitreous injection ranged from 0 to 2 days. Among them, After IVR, there were two eyes had IOP greater than 30mmHg within 30 minutes, four eyes showed normal IOP at 30 min, and then developed ghost cell glaucoma within 1 day, two eyes developed ghost cell glaucoma between 24 and 48 hours. The mean maximum IOP was 46.5±8.0 mmHg. All patients gained normal IOP after vitrectomy without medicine for lowering IOP. The presence of ghost cell glaucoma was associated with tractional retinal detachment (RR= 4.60 [2.02~8.48], p= 0.004) and fibrovascular membrane involving disk (RR=-3.57 [-7.59~-0.92], p=0.03) (AIC= 39.23，AUC=0.88) in a logistic regression model.CONCLUSION: Attention to postoperative IOP should be paid to patients with PDR undergoing vitrectomy who receive a preoperative intravitreous injection of anti-VEGF agents. PDR patients with tractional retinal detachment or fibrovasucular membrane involving optic disc are more likely to develop ghost cell glaucoma after IVR.

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 Visual outcomes and complications following one-way air-fluid exchange technique for vitreous hemorrhage post vitrectomy in proliferative diabetic retinopathy patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qun Wang ◽  
Jie Zhao ◽  
Qing Xu ◽  
Cui Han ◽  
Baojie Hou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Saline Solution ◽  
Case Series ◽  
Vitreous Hemorrhage ◽  
Retrospective Case ◽  
Fluid Exchange ◽  
The One

AbstractBackgroundTo evaluate the efficacy and outcomes of one-way surgical technique for the treatment of vitreous hemorrhage post vitrectomy on proliferative diabetic retinopathy (PDR) patients.MethodsThis retrospective case series include 47 PDR patients who had vitrectomy with balanced saline solution tamponade and have developed vitreous hemorrhage without significant absorption. The one-way air-fluid exchange procedure which involves the application of a 0.22-μm pore size filter to exchange about 4.5–5.5 ml of fluid with a 10 ml syringe was performed on 47 patients (47 eyes). Post procedure, additional treatments were administered when needed. Best corrected visual acuity (BCVA), occurrence of intra-procedural and post-procedural complications were recorded and analyzed.ResultsA total of 47 eyes of 47 PDR patients with a mean age of 50.8 ± 12.0 years were reviewed. Because of vitreous hemorrhage or tractional retinal detachment of PDR, all 47 eyes underwent vitrectomy with balanced saline solution tamponade prior to the exchange procedure. Four patients (8.51%) and 43 patients (91.5%) were diagnosed with type 1 diabetes mellitus (T1DM), or type 2 diabetes mellitus (T2DM), respectively. All 47 eyes were given the one-way air-fluid exchange procedure in the treatment room. Forty-two cases (89.4%) needed the air-fluid exchange procedure only once, 4 cases (8.51%) underwent the procedure twice, and 1 case (2.13%) was given the procedure three times, followed by additional retinal photocoagulation and one intravitreal injection of Conbercept. In addition to the procedure, no further treatment was needed for 5 eyes (10.6%) while additional retinal laser treatment was provided for 41 eyes (87.2%). The BCVA at the final follow-up was significantly improved from the initial acuity baseline in all cases. No complications were observed during the follow-ups.ConclusionThis one-way air-fluid exchange procedure can effectively exchange the vitreous hemorrhage and improve visual acuity of PDR patients who develop vitreous rehemorrhage post vitrectomy without obvious complications.

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

2020 ◽  
Author(s):  
Jun XU ◽  
Meng ZHAO ◽  
Jipeng LI ◽  
Ningpu LIU
Keyword(s):  
Logistic Regression ◽  
Retinal Detachment ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Case Series ◽  
Stepwise Logistic Regression ◽  
Ghost Cell ◽  
Tractional Retinal Detachment ◽  
Intravitreous Injection ◽  
Case Series Study

Abstract BACKGROUND: The development of ghost cell glaucoma in patients with PDR after intravitreous injection (IV) was rare. Here we reported a series of patients with PDR who received Intravitreous Ranibizumab (IVR) and developed ghost cell glaucoma and analyzed the potential factors that might be related to the development of ghost cell glaucoma. METHODS: Retrospective case series study. The medical records of 71 consecutive eyes of 68 PDR patients who received vitrectomy after IVR from January 2015 to January 2017 were reviewed. The development of ghost cell glaucoma after IVR was recorded. Characteristics of enrolled patients were retrieved from their medical charts. Factors associated with ghost cell glaucoma were compared between eyes with the development of ghost cell glaucoma and eyes without the development of ghost cell glaucoma. Variables were further enrolled in a binary backward stepwise logistic regression model, and the model that had the lowest AIC was chosen. 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 intraocular pressure ( IOP ) and IV ranged from 0 to 2 days. Among them, after IVR, there were two eyes had IOP greater than 30mmHg within 30 minutes, four eyes showed normal IOP at 30 min, and then developed ghost cell glaucoma within 1 day, two eyes developed ghost cell glaucoma between 24 and 48 hours. The mean IOP was 46.5±8.0 mmHg. All patients gained normal IOP after vitrectomy without medicine for lowering IOP. The presence of ghost cell glaucoma was associated with tractional retinal detachment (RR=4.60 [2.02~8.48], p=0.004) and fibrovascular membrane involving disk (RR=-3.57 [-7.59~-0.92], p=0.03) (AIC= 39.23，AUC=0.88) in a logistic regression model. CONCLUSION: Attention to postoperative IOP should be paid to patients with PDR undergoing vitrectomy who receive a preoperative IV of anti-VEGF agents. PDR patients with tractional retinal detachment or fibrovasucular membrane involving optic disc are more likely to develop ghost cell glaucoma after IV.

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.

scholarly journals The Effect of Chromium in the Management of Diabetic Macular Edema: An Interventional Comparative Case Series

2021 ◽  
Vol 8 (2) ◽  
pp. 1-6
Author(s):  
Suresh K Karri ◽  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Proliferative Diabetic Retinopathy ◽  
Case Series ◽  
Macular Thickness ◽  
Case Series Study ◽  
Series Study

Objective of the present study was to investigate the effect of chromium polynicotinate supplementation on the visual acuity and macular thickness of the diabetic macular edema in patients with non-proliferative diabetic retinopathy through a prospective, interventional comparative case series study, was performed in 120 patients.

scholarly journals The Effect of HbA1c Variability as a Risk Measure for Microangiopathy in Type 1 Diabetes Mellitus

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1151
Author(s):  
Pedro Romero-Aroca ◽  
Raul Navarro-Gil ◽  
Albert Feliu ◽  
Aida Valls ◽  
Antonio Moreno ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Diabetic Retinopathy ◽  
Type 1 Diabetes Mellitus ◽  
Risk Measure ◽  
Case Series ◽  
Multivariate Statistical ◽  
Case Series Study ◽  
Prospective Case Series

Background: To measure the relationship between variability in HbA1c and microalbuminuria (MA) and diabetic retinopathy (DR) in the long term. Methods: A prospective case-series study, was conducted on 366 Type 1 Diabetes Mellitus patients with normoalbuminuria and without diabetic retinopathy at inclusion. The cohort was followed for a period of 12 years. The Cox survival analysis was used for the multivariate statistical study. The effect of variability in microangiopathy (retinopathy and nephropathy) was evaluated by calculating the standard deviation of HbA1c (SD-HbA1c), the coefficient of variation of HbA1c (CV-HbA1c), average real variability (ARV-HbA1c) and variability irrespective of the mean (VIM-HbA1c) adjusted for the other known variables. Results: A total of 106 patients developed diabetic retinopathy (29%) and 73 microalbuminuria (19.9%). Overt diabetic nephropathy, by our definition, affected only five patients (1.36%). Statistical results show that the current age, mean HbA1c, SD-HbA1c and ARV-HbA1c are significant in the development of diabetic retinopathy. Microalbuminuria was significant for current age, mean HbA1c, CV-HbA1c and ARV-HbA1c. Conclusions: By measuring the variability in HbA1c, we can use SD-HbA1c and ARV-HbA1c as possible targets for judging which patients are at risk of developing DR and MA, and CV-HbA1c as the target for severe DR.

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