scholarly journals Surgical Treatment of Diabetic Recurrent Vitreous Hemorrhage and Traction Retinal Detachment

2018 ◽  
pp. 202-207
Keyword(s):  
Diabetes Mellitus ◽  
Vascular Endothelial Growth Factor ◽  
Diabetic Retinopathy ◽  
Surgical Treatment ◽  
High Frequency ◽  
Vitreoretinal Surgery ◽  
Vitreous Hemorrhage ◽  
Vascular Endothelial ◽  
Endothelial Growth Factor ◽  
Recurrent Vitreous Hemorrhage

Although the irreversible proliferative complications of diabetes are less visible with anti-vascular endothelial growth factor (anti-VEGF) agents, surgical treatment is still important for these groups of patients; because of the high frequency of diabetes mellitus. The most common indications for vitreoretinal surgery for proliferative diabetic retinopathy are vitreous hemorrhages and tractional retinal detachments. This review summarized the surgical treatment of these two complications.

scholarly journals Change of Vascular Endothelial Growth Factor Levels following Vitrectomy in Eyes with Proliferative Diabetic Retinopathy

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Hui-Jin Chen ◽  
Zhi-Zhong Ma ◽  
Ying Li ◽  
Chang-Guan Wang
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Diabetic Retinopathy ◽  
Growth Factor ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Enzyme Linked Immunosorbent Assay ◽  
Vascular Endothelial ◽  
Endothelial Growth Factor ◽  
Vegf Level ◽  
Recurrent Vitreous Hemorrhage

Purpose. To study the change of concentrations of vascular endothelial growth factor (VEGF) in vitreous cavity after vitrectomy in eyes with proliferative diabetic retinopathy (PDR). Methods. In this retrospective study, intravitreal fluid samples were taken at baseline (beginning of the vitrectomy) and postoperatively (several days later after vitrectomy) at the time of prophylactic injection of bevacizumab in forty-eight eyes of forty-eight patients with PDR. Postvitrectomy fluid samples were divided into four groups according to the time interval between the vitrectomy and the injection (group 1, 3–5 days; group 2, 6–10 days; group 3, 11–15 days; group 4, 16–21 days; twelve eyes in each group). Postvitrectomy fluid sample was paired with baseline sample for each eye. VEGF concentrations in the samples were determined by enzyme-linked immunosorbent assay. Recurrent vitreous hemorrhage and neovascular glaucoma within six months postvitrectomy were also analyzed. Results. Overall, the intravitreal VEGF level after vitrectomy (median, 36.95 pg/ml; range, 3.2–1,299.4 pg/ml) was significantly less than the VEGF level at baseline (median, 704.5 pg/ml; range, 30.6–1,981.1 pg/ml). Postoperative and baseline VEGF levels were significantly correlated (r = 0.499, p<0.01). Both the absolute value of postoperative VEGF concentrations and the postop/baseline VEGF ratios declined with time and dramatically decreased in groups 3 and 4. In only two eyes, the postoperative VEGF level was even higher than the baseline VEGF level (postop/baseline VEGF ratio >1), and recurrent vitreous hemorrhage developed within six months in these two eyes. Conclusions. After vitrectomy for PDR, intravitreal VEGF levels decreased substantially in the majority of patients, while persistent high-VEGF level occurred in a few individuals. Postoperative VEGF levels and postop/baseline VEGF ratio declined with time. The postop/preop VEGF ratio may serve as a predictor for late complications.

scholarly journals Vascular endothelial growth factor (VEGF)-related polymorphisms rs10738760 and rs6921438 are not risk factors for proliferative diabetic retinopathy (PDR) in patients with type 2 diabetes mellitus (T2DM)

2019 ◽  
Vol 19 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Jana Sajovic ◽  
Ines Cilenšek ◽  
Sara Mankoč ◽  
Špela Tajnšek ◽  
Tanja Kunej ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Vascular Endothelial Growth Factor ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Diabetic Patients ◽  
Vascular Endothelial ◽  
Endothelial Growth Factor

Vascular endothelial growth factor (VEGF) is an important regulator of angiogenesis and has been investigated as a candidate gene in a number of conditions, including diabetes and its microvascular complications (e.g., retinopathy and nephropathy). Several VEGF-related polymorphisms have been shown to contribute to nearly half of the variability in circulating VEGF levels in healthy individuals. Our aim was to assess the association between VEGF-related rs10738760 and rs6921438 polymorphisms and proliferative diabetic retinopathy (PDR) in Slovenian patients with type 2 diabetes mellitus (T2DM). We also investigated the effect of these polymorphisms on VEGF receptor 2 (VEGFR-2) expression in fibrovascular membranes (FVMs) from patients with PDR. This case-control study enrolled 505 unrelated patients with T2DM: 143 diabetic patients with PDR as a study group, and 362 patients with T2DM of >10 years duration and with no clinical signs of PDR as a control group. Patient clinical and laboratory data were obtained from their medical records. rs10738760 and rs6921438 polymorphisms were genotyped using TaqMan SNP Genotyping assay. VEGFR-2 expression was assessed by immunohistochemistry in 20 FVMs from patients with PDR, and numerical areal density of VEGFR-2-positive cells was calculated. The occurrence of PDR was 1.7 times higher in diabetic patients carrying GA genotype of rs6921438 compared to patients with GG genotype, with a borderline statistical significance (OR = 1.7, 95% CI = 1.00 – 2.86, p = 0.05). In addition, A allele of rs6921438 was associated with increased VEGFR-2 expression in FVMs from PDR patients. However, we observed no association between AA genotype of rs6921438 nor between rs10738760 variants and PDR, indicating that the two polymorphisms are not genetic risk factors for PDR.

scholarly journals Análise da Revisão Cochrane: Anti-fator de Crescimento Vascular Endotelial na Prevenção da Hemorragia Vítrea Pós-Operatória após Vitrectomia por Retinopatia Diabética Proliferativa. Cochrane Database Syst Rev. 2015;8:CD008214.

2017 ◽  
Vol 30 (7-8) ◽  
pp. 513 ◽  
Author(s):  
David Cordeiro Sousa ◽  
Inês Leal ◽  
João Costa ◽  
António Vaz-Carneiro
Keyword(s):  
Systematic Review ◽  
Vascular Endothelial Growth Factor ◽  
Diabetic Retinopathy ◽  
Growth Factor ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Vascular Endothelial ◽  
Cochrane Systematic Review ◽  
Endothelial Growth Factor ◽  
Postoperative Vitreous Hemorrhage

Postoperative vitreous hemorrhage is a complication following vitrectomy for proliferative diabetic retinopathy, delaying visual recovery and making fundus examination and disease follow-up more difficult. Anti-vascular endothelial growth factor drugs such as bevacizumab, when injected in the vitreous cavity, reduce vascular proliferation and their use has been proposed to reduce the incidence of postoperative vitreous hemorrhage. The authors of this Cochrane systematic review evaluated all randomized controlled trials on the pre- or intraoperative use of anti-vascular endothelial growth factor to reduce postoperative vitreous hemorrhage occurrence after vitrectomy in patients with proliferative diabetic retinopathy. The results suggested that the use of intravitreal bevacizumab was effective in reducing early postoperative vitreous hemorrhage (i.e. at four weeks) occurrence, with a good safety profile. This work aims to summarize and discuss the findings and clinical implications of this Cochrane systematic review.

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 Association of vascular endothelial growth factor A gene (VEGFA) polymorphisms, rs699947 and rs1570360, with diabetic retinopathy and altered VEGF secretion in Pakistani patients with Type 2 diabetes mellitus: A case-control study

2020 ◽  
Author(s):  
Shazia Qayyum ◽  
Muhammad Afzal ◽  
Abdul Khaliq Naveed
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vascular Endothelial Growth Factor ◽  
Diabetic Retinopathy ◽  
Case Control Study ◽  
Case Control ◽  
Vascular Endothelial ◽  
Endothelial Growth Factor ◽  
Control Study

Abstract Background: The incidence of type 2 diabetes mellitus (T2DM) is rising in working age adults in Pakistan. Diabetic patients have a greater chance for developing diabetic retinopathy (DR). There is negligible research on the genetic factors contributing to DR in Pakistani population. This study was done to investigate the association of vascular endothelial growth factor A gene (VEGFA) polymorphisms, 2578 C/A (rs699947) and 1154 G/A (rs1570360) with T2DM, diabetic retinopathy and serum VEGF levels in Pakistani patients. Methods: A case-control study, conducted from Jan 2017 to Dec 2018, including 450 subjects: 150 DR, 150 diabetics without retinopathy (DWR) and 150 healthy controls (HC). Genotyping was done by ARMS-PCR and serum VEGF levels were measured by ELISA. Descriptive and inferential statistics were calculated to compare genotypic / allelic frequencies and biochemical variables. Results: No statistically significant association of rs699947 and rs1570360 genotypic and allelic frequencies were found with DR as compared to DWR. The rs699947 heterozygosity was associated with DWR and homozygous mutant allele A with DWR and DR as compared to HC. Upon stratifying DR into non- proliferative (NPDR) and proliferative (PDR) sub- types, rs699947 AA genotype was significantly associated with PDR as compared to DWR in univariate and multinomial regression analysis. In allelic, dominant and recessive models, the minor allele A showed significant association with DWR and DR as compared to HC. Significantly raised serum VEGF levels were found in DR patients as compared to DWR and were associated with rs699947 and rs1570360 heterozygosity in DWR. Serum VEGF showed a positive correlation with fasting plasma glucose (FPG), cholesterol and LDL-C in DR and DWR groups. rs699947 genotype showed significant association with DWR and DR in Punjabi and Pathan and with DR in Kashmiri ethnic groups compared to HC. rs1570360 was significantly association with DR as compared to DWR in Kashmiri ethnic group. Conclusion: Our study endorses the role of VEGF 2578C/A (rs699947) gene polymorphism in the pathogenesis of T2DM and proliferative diabetic retinopathy in Pakistani patients. Serum VEGF levels have a positive correlation with T2DM and severity of DR.

VASCULAR ENDOTHELIAL GROWTH FACTOR IN OCULAR FLUID OF PATIENTS WITH DIABETIC RETINOPATHY AND OTHER RETINAL DISORDERS

PEDIATRICS ◽  
1995 ◽  
Vol 95 (3) ◽  
pp. A44-A44
Author(s):  
J. F. L.
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Diabetic Retinopathy ◽  
Growth Factor ◽  
Vitreous Hemorrhage ◽  
Angiogenic Factor ◽  
Retinal Diseases ◽  
Vascular Endothelial ◽  
Vein Occlusion ◽  
Retinal Disorders ◽  
Endothelial Growth Factor

Background. Retinal ischemia induces intraocular neovascularization, which often leads to glaucoma, vitreous hemorrhage, and retinal detachment, presumably by stimulating the release of angiogenic molecules. Vascular endothelial growth factor (VEGF) is an endothelial-cell-specific angiogenic factor whose production is increased by hypoxia. Conclusions. Our data suggest that VEGF plays a major part in mediating active intraocular neovascularization in patients with ischemic retinal diseases, such as diabetic retinopathy and retinal-vein occlusion.

Sign in / Sign up

Export Citation Format

Share Document