scholarly journals Clinical Features and Treatment of Inactive Proliferative Diabetic Retinopathy

2021 ◽  
Author(s):  
Weiting An ◽  
Qi Zhao ◽  
Longli Zhang ◽  
Jindong Han
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Optic Disc ◽  
Clinical Features ◽  
Proliferative Diabetic Retinopathy ◽  
Peripheral Retina ◽  
Panretinal Photocoagulation ◽  
Retinal Break ◽  
Small Branch ◽  
Vascular Arcade

Abstract Background To investigate the clinical features and results after vitrectomy for inactive proliferative diabetic retinopathy (IPDR).Methods Retrospective review of 40 eyes of 21 IPDR patients who underwent 23G or 25G minimally invasive vitrectomy between January 2018 and December 2019 in Tianjin Medical University Eye Hospital.The average follow-up period was 8.7 months. Outcome measures were best-corrected visual acuity (BCVA), clinical features and intraoperative findings of IPDR.Results All eyes were performed with panretinal photocoagulation (PRP) for average 1.6 years before operation. Fundus examination showed the optic disc was pale, and a mass of yellowish-white fibroproliferative membrane was around the optic disc and vascular arcade. Thirty-three eyes (82.5%) were accompanied by tractional retinal detachment, and macula was involved in 9 eyes (22.5%). The vitreous adhered with the retina tightly. The mid-peripheral retina was thin. Thirty-one eyes (77.5%) were accompanied by small branch retinal artery and vein occlusion. Fourteen eyes (35.0%) occurred iatrogenic retinal break during vitrectomy. The median LogMAR of BCVA significantly improved from 1.0 (20/200)preoperatively to 0.92 (20/167) postoperatively (P = 0.000).Conclusions The fundus manifestation of IPDR was quiet and special. Vitrectomy could improve patients’ visual acuity, but the incidence of iatrogenic retinal break was high.Vitrectomy could be performed by well-skilled vitro-retinal surgeons according to the minimum quantitative principle.

scholarly journals Triamcinolone and Bevacizumab as Adjunctive Therapies to Panretinal Photocoagulation for Proliferative Diabetic Retinopathy

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
F. Lopez-Lopez ◽  
F. Gomez-Ulla ◽  
M. J. Rodriguez-Cid ◽  
L. Arias
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Contrast Sensitivity ◽  
Proliferative Diabetic Retinopathy ◽  
Panretinal Photocoagulation ◽  
Central Macular Thickness ◽  
Intravitreal Triamcinolone ◽  
Corrected Visual Acuity ◽  
Best Corrected Visual Acuity

Purpose. To evaluate efficacy of intravitreal triamcinolone (IVT) and bevacizumab (IVB) as adjunctive treatments to panretinal photocoagulation (PRP) in proliferative diabetic retinopathy (PDR). Methods. In 60 eyes of 45 patients with PDR, PRP (PRP group), PRP with IVT (IVT group), or PRP with IVB (IVB group) was performed. Regression of new vessels (NV), changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), and contrast sensitivity at 1,2, and 6 months were evaluated. Results. Initial mean numbers of active NV and BCVA were 3.45 and 67.35 in the PRP group, 4.35 and 76.65 in the IVT group, and 4.79 and 75.53 in the IVB group. At the 6-month follow-up, numbers of active NV were 2.5 (P=0.064), 1.11 (P=0.000), and 1.11 (P=0.002), and there was a mean loss of 2,6 (P=0.055), 3.9 (P=0.011), and 0.9 letters (P=0.628) in the PRP, IVT, and IVB groups, respectively. Changes in CMT in the PRP and IVT groups were not significant, but significantly increased in the IVB group (P=0.032). Contrast sensitivity remained stable in PRP and IVB groups and slightly decreased in IVT group. Conclusions. Adjunctive use of both triamcinolone and bevacizumab with PRP lead to a greater reduction of active NV than PRP alone in PDR, although no differences were seen between the two of them.

scholarly journals Need for vitreous surgeries in proliferative diabetic retinopathy in 10 years follow-up: India Retinal Disease Study (IRDS) group Report no.2

2020 ◽  
Author(s):  
Rehana Khan ◽  
Janani Surya ◽  
Ramachandran Rajalakshmi ◽  
Padmaja Kumari Rani ◽  
Giridhar Anantharaman ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Cataract Surgery ◽  
Proliferative Diabetic Retinopathy ◽  
Low Risk ◽  
Study Cohort ◽  
Panretinal Photocoagulation ◽  
Vitreous Surgery ◽  
Retinal Surgery

Introduction: To report the 10 - year rate of vitrectomies and the associated factors in people with proliferative diabetic retinopathy (PDR) from a multicentric cohort of people with diabetes mellitus. Methods: Ten centres in India with established vitreoretinal services for over 10 years were invited to provide long-term data on PDR. People with Type 1 or 2 diabetes with a clinical diagnosis of active PDR in one or both eyes were included. Baseline data collected included age, sex, duration of diabetes, source of referral and best-corrected visual acuity and diabetic retinopathy status in both eyes. Available follow-up data included the numbers of panretinal photocoagulation (PRP) sessions, cataract surgery, treatment of diabetic macular edema, use of anti- vascular endothelial growth factor therapy, vitrectomy with or without retinal surgeries over 10 years. Results: Over 10 years, 89 % needed supplemental PRP after initial complete PRP. One – third required retinal surgery, 16 % needed intravitreal injection. Men (74.5%) had significant higher risk for vitreous surgery. Of the group with low risk PDR, 56.8% did not require vitreoretinal surgery, p <0.001. Of the patients who underwent cataract surgery and had intravitreal anti-VEGF injections, 78.5% and 28.2% needed subsequent vitreous surgery (VR), p=0.006 and <0.0001 respectively. Independent predictors of need for vitreo-retinal surgery included those who underwent cataract surgery and those with poor baseline visual acuity (logMAR). Eyes at lower risk for VR surgery included the eyes previously treated with PRP and low-risk PDR at baseline. Conclusion: Despite initial ‘complete’ PRP, one third of our study cohort needed vitrectomies over 10 years, highlighting that these patients require regular follow-up for a long period of time.

scholarly journals Effect of Intravitreous Aflibercept vs Vitrectomy With Panretinal Photocoagulation on Visual Acuity in Patients With Vitreous Hemorrhage From Proliferative Diabetic Retinopathy

JAMA ◽  
2020 ◽  
Vol 324 (23) ◽  
pp. 2383
Author(s):  
Andrew N. Antoszyk ◽  
Adam R. Glassman ◽  
Wesley T. Beaulieu ◽  
Lee M. Jampol ◽  
Chirag D. Jhaveri ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Panretinal Photocoagulation

Comparing Two Techniques of Panretinal Photocoagulation on Visual Acuity on Patients with Proliferative Diabetic Retinopathy

2012 ◽  
Vol 66 (5) ◽  
pp. 321 ◽  
Author(s):  
Zeljko Kovacic ◽  
Milan Ivanisevic ◽  
Lovro Bojic ◽  
Zlatko Hrgovic ◽  
Mladen Lesin ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Panretinal Photocoagulation

scholarly journals Vitrectomy for Proliferative Diabetic Retinopathy in a Patient with Heparin-Induced Thrombocytopenia

2016 ◽  
Vol 7 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Tomoko Fujii ◽  
Mari Akashi ◽  
Seita Morishita ◽  
Masanori Fukumoto ◽  
Hiroyuki Suzuki ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Diabetic Nephropathy ◽  
Retinal Detachment ◽  
Proliferative Diabetic Retinopathy ◽  
Chief Complaint ◽  
Dialysis Treatment ◽  
Heparin Induced Thrombocytopenia ◽  
Postoperative Course ◽  
Vascular Arcade

Introduction: In this study, we report a case of proliferative diabetic retinopathy in a patient with heparin-induced thrombocytopenia (HIT) in whom vitrectomy was performed with good results. Case: A 57-year-old man presented with a chief complaint of decreased visual acuity (VA) in the left eye. Corrected VA of the left eye was 0.03, and ophthalmic examination showed fibrovascular membranes along the vascular arcade and a combined rhegmatogenous-traction retinal detachment with a macular hole. The patient began hemodialysis for diabetic nephropathy in March 2014; thrombocytopenia developed after dialysis was started, and HIT was diagnosed after further evaluation. Argatroban hydrate was being used during dialysis. Treatment was switched from warfarin to argatroban hydrate 6 days prior to vitrectomy being performed on the patient's left eye. Although there was bleeding with somewhat difficult hemostasis during the intraoperative treatment of the fibrovascular membranes, surgery was completed without complications and the postoperative course was good. Discussion: Vitrectomy was performed with good results in this patient with HIT. Treatment with argatroban hydrate during surgery enabled surgery without the danger of intraoperative clotting.

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 Tear fluid vascular endothelial growth factor level as a marker of effectiveness of proliferative diabetic retinopathy combined treatment

2012 ◽  
Vol 93 (6) ◽  
pp. 965-969
Author(s):  
A N Samoilov ◽  
I G Mustafin ◽  
A N Korobitsyn
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Growth Factor ◽  
Proliferative Diabetic Retinopathy ◽  
Tear Fluid ◽  
Panretinal Photocoagulation ◽  
Vascular Endothelial ◽  
Intravitreal Ranibizumab ◽  
Endothelial Growth Factor

Aim. To assess the tear fluid level of vascular endothelial growth factor in patients with proliferative diabetic retinopathy in case of panretinal photocoagulation and intravitreal ranibizumab treatment. Methods. Panretinal photocoagulation was performed in 20 patients (40 eyes) with proliferative diabetic retinopathy (first group). In the second group, which included 20 patients (40 eyes) with the same stage of diabetic retinopathy, panretinal photocoagulation was combined with intravitreal ranibizumab treatment. 20 healthy subjects (40 eyes) were examined as a contol group. There were no adverse events registered during the treatment. At the follow-up, 4 patients from the first group were diagnosed with partial intraocular hemorrhage; a posterior vitrectomy was required in 1 eye, in 3 eyes intraocular hemorrhage has resolved spontaneously. A complex of clinical and laboratory examinations included visual acuity testing, biomicroscopy, indirect ophthalmoscopy using Mainster wide field lens, fluorescein angiography, optical coherence tomography, tear fluid ELISA. Results. There was a complete regression of retinal neovascularization (no blood flow in newly grown blood vessels) in 14 (35%) eyes of patients from the first group after the first procedure. In the second group a complete regression of retinal neovascularization was observed in 100% of cases after the first procedure. The tear fluid level of vascular endothelial growth factor increased from 398.6±112.2 to 668.2±102.2 pg/ml (p 0.05) in 40 (100%) eyes of patients from the first group, in the second group the level of vascular endothelial growth factor decreased after the angiogenesis inhibitor injections in 40 eyes (100%) from 332.1±98.2 до 314.6±44.4 pg/ml (p 0.05). 1 month after treatment the visual acuity in the first group the visual acuity improved in 40% of cases (16 eyes), was stable in 45% (18 eyes), decreased in 15% (6 eyes) with the mean value changed from 0.22±0.12 to 0.24±0.08 (p 0.05); in the second group the visual acuity improved in 40% of cases (16 eyes), was stable in 45% (18 eyes), decreased in 15% (6 eyes) with the mean value changed from 0.22±0.12 to 0.24±0.08 (p 0.05). Conclusion. The use of panretinal photocoagulation combined with intravitreal ranibizumab treatment in patients with proliferative diabetic retinopathy decreases the tear fluid vascular endothelial growth factor level, improves the visual acuity and thickness of the retina. There was a marked and prolonged effect after the combined treatment, that allows to recommend this treatment method to all patients with proliferative diabetic retinopathy.

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