Octreotide Reduces Vitreous Hemorrhage and Loss of Visual Acuity Risk in Patients with High-Risk Proliferative Diabetic Retinopathy

2001 ◽  
Vol 33 (5) ◽  
pp. 300-306 ◽  
Author(s):  
B. O. Boehm ◽  
G. K. Lang ◽  
P. M. Jehle ◽  
B. Feldmann ◽  
G. E. Lang
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
High Risk ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Loss Of Visual Acuity

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

scholarly journals Visual outcomes and complications following One-way Air-fluid exchange technique for vitreous hemorrhage post vitrectomy in proliferative diabetic retinopathy patients

2020 ◽  
Author(s):  
Qun Wang ◽  
Jie Zhao ◽  
Qing Xu ◽  
Cui Han ◽  
Baojie Hou ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Fluid Exchange ◽  
Treatment Room ◽  
Procedural Complications ◽  
The One

Abstract Background To evaluate the efficacy and outcomes following one-way surgical technique for the treatment of vitreous hemorrhage post vitrectomy in proliferative diabetic retinopathy (PDR) patients. Methods Those PDR patients who had vitrectomy with balance saline tamponade and then developed vitreous hemorrhage post vitrectomy were included in this study. 47 patients underwent the one-way air-fluid exchange surgical procedure with a 10 ml syringe used to exchange between 4.5–5.5 ml of fluid in the treatment room. After the air-fluid surgical exchange procedure, additional treatments were administered when needed. Best corrected visual acuity (BCVA) and occurrence of intra-procedural and post-procedural complications were collected and analyzed. Results A total of 47 eyes of 47 PDR patients with a mean age of 50.8 ± 12.0 years were reviewed. All 47 eyes had undergone vitrectomy with balance saline tamponade because of PDR. 4 of them were diagnosed with type 1 diabetes mellitus (T1DM), and 43 of them were diagnosed with type 2 diabetes mellitus (T2DM). All the 47 eyes were given the one-way air-fluid exchange procedure in the treatment room. In 4 cases the procedure was administered twice, and in 1 case the procedure was administered three times, followed by additional retinal photocoagulation and one intravitreal injection of Conbercept. 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. Conclusion This one-way air-fluid exchange procedure could effectively exchange the vitreous hemorrhage and improve visual acuity without obvious complications in treating vitreous hemorrhage post vitrectomy.

scholarly journals Factors correlated with visual outcomes at two and four years after vitreous surgery for proliferative diabetic retinopathy

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244281
Author(s):  
Katsuhiro Nishi ◽  
Koichi Nishitsuka ◽  
Teiko Yamamoto ◽  
Hidetoshi Yamashita
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Severe Case ◽  
Vitreous Surgery ◽  
Data Set ◽  
Postoperative Visual Acuity ◽  
Treatment Provision

Proliferative diabetic retinopathy (PDR) is the most severe case of diabetic retinopathy that can cause visual impairment. This study aimed to reveal the factors correlated with better postoperative visual acuity after a long follow-up in patients who underwent vitrectomy for PDR. We retrospectively analyzed the data set including systemic findings, ocular findings, and surgical factors from registered patients who could be completely followed up for 2 or 4 years after vitrectomy. We ultimately enrolled 128 eyes from 100 patients who underwent vitrectomy for PDR between January 2008 and September 2012 and were followed up for >2 years. Among them, 91 eyes from 70 patients could be followed up for 4 years. Factors related to the postoperative visual acuity of ≥20/40 and ≥20/30 after 2 and 4 years were investigated by logistic regression analysis. Better postoperative visual acuity correlated with the following factors: no rubeosis iridis ([≥20/40 at 2 years; odds ratio {OR}, 0.068; 95% confidence interval {CI}, 0.012–0.39; P = 0.003], [≥20/30 at 2 years; OR, 0.07; 95% CI, 0.01–0.40; P = 0.03], [≥20/30 at 4 years; OR, 0.078; 95% CI, 0.006–0.96; P = 0.04]), no fibrovascular membrane [(≥20/40 at 2 years; OR, 0.22; 95% CI, 0.061–0.81; P = 0.02), (≥20/40 at 4 years; OR, 0.26; 95% CI, 0.07–0.94; P = 0.04), (≥20/30 at 4 years; OR, 0.14; 95% CI, 0.04–0.52; P = 0.004)], existing vitreous hemorrhage (≥20/30 at 2 years; OR, 9.55; 95% CI, 1.03–95.27; P = 0.04), and no reoperation ([≥20/40 at 4 years; OR, 0.15; 95% CI, 0.03–0.78; P = 0.02], [≥20/30 at 4 years; OR, 0.06; 95% CI, 0.07–0.54; P = 0.01]). Treatment provision before disease severity and treatment without complications were associated with good postoperative visual acuity.

scholarly journals Intravitreal bevacizumab (IVB) versus IVB in combination with pars plana vitrectomy for vitreous hemorrhage secondary to proliferative diabetic retinopathy: a randomized clinical trial

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Danilo Moyses Jorge ◽  
José Edísio da Silva Tavares Neto ◽  
Omero Benedicto Poli-Neto ◽  
Ingrid U. Scott ◽  
Rodrigo Jorge
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Pars Plana Vitrectomy ◽  
Vitreous Hemorrhage ◽  
Sao Paulo ◽  
Group A ◽  
Pars Plana ◽  
Group B

Abstract Background The main purpose of this study is to compare the vitreous hemorrhage (VH) score reduction and visual acuity outcomes in patients with VH secondary to proliferative diabetic retinopathy (PDR) treated with intravitreal injections of bevacizumab (IVB) versus IVB and pars plana vitrectomy (IVB and PPV). Methods Patients with VH secondary to PDR were randomized into 2 groups: in Group A, patients were treated with a total of 3 IVB (1.5 mg/0.06 ml) at 8-week intervals; and in Group B, patients received a single IVB (1.5 mg/0.06 ml) and, 7 days later, underwent PPV. Patients received an ophthalmic evaluation that included best-corrected visual acuity (BCVA), indirect ophthalmoscopy, and mode B echography at weeks 8, 16 and 24. VH was classified according to the Diabetic Retinopathy Vitrectomy Study classification as grade 1, 2 or 3. Change in VH score was the primary outcome measure and change in BCVA was the secondary outcome. Results Seventy-three eyes of 66 patients were randomized and 70 eyes completed the 24-week follow-up visit. Mean VH score reduction (± SEM) of 0.4571 ± 0.0283 (p = 0.0014), 1.3429 ± 0.0393 (p < 0.0001) and 1.8286 ± 0.0438 (p < 0.001) was observed in Group A at 8, 16 and 24 weeks after treatment, respectively (Table 2; Fig. 2). In Group B, the reduction of VH score (± SEM) was 2.2571 ± 0.0720 (p = 0.0014), 2.2857 ± 0.0606 (p < 0.0001) and 2.2286 ± 0.0726 (p < 0.001) at 8, 16 and 24 weeks after treatment, respectively. Group comparison revealed a significantly greater reduction in mean VH score in Group B at 8 and 16 weeks after treatment (p < 0.0001). However, at 24 weeks this difference was no longer statistically significant (p = 0.1854). In Group A, mean (± SEM) BCVA showed an improvement of 0.00285 ± 0.0004 (p = 0.971), 0.5371 ± 0.0072 (p < 0.0001), 0.8143 ± 0.0001 (p < 0.0001) and 0.8543 ± 0.0008 (p < 0.0001) compared to baseline at 1, 8, 16 and 24 weeks after treatment, respectively. In Group B, mean (± SEM) BCVA showed an improvement of 0.3657 ± 0.0507 (p = 0.0002), 0.8857 ± 0.0385 (p < 0.0001), 0.9457 ± 0.0499 (p < 0.0001) and 0.9629 ± 0477 (p < 0.0001) compared to baseline at 1, 8, 16 and 24 weeks after treatment, respectively. No significant difference in BCVA improvement was observed between groups at 24 weeks after treatment. Conclusion PPV with preoperative IVB is associated with more rapid clearance of VH and improvement in BCVA than IVB injections alone. However, after 24 weeks of follow-up, the reduction in VH score and BCVA were similar between both treatment strategies. Trial Registration The project is registered in Plataforma Brasil with CAAE number 927354.7.0000.5440 and was approved by the Ethics Committee of the Clinics Hospital of Ribeirao Preto Medicine School of São Paulo University—Ribeirão Preto, São Paulo, Brazil (appreciation number 3.053.397 gave the approval).

scholarly journals Attaining functional levels of visual acuity after vitrectomy for retinal detachment secondary to proliferative diabetic retinopathy

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Aaron Ricca ◽  
Kiley Boone ◽  
H. Culver Boldt ◽  
Karen M. Gehrs ◽  
Stephen R. Russell ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Retinal Detachment ◽  
Activities Of Daily Living ◽  
Proliferative Diabetic Retinopathy ◽  
Daily Living ◽  
Low Vision ◽  
Visual Fields ◽  
Vitreous Hemorrhage ◽  
World Health

Abstract Most patients needing diabetic tractional retinal detachment (TRD) surgery are working-age adults that drive and participate in other vision-dependent activities of daily living. We sought to determine the proportion of patients that achieve functional visual acuity (VA) based on the World Health Organization (WHO) definition of ‘low vision’ (≤ 20/80) and US driving standards (≥ 20/40) after vitrectomy for diabetic TRD. In this 10-year retrospective review, consecutive patients who underwent primary vitrectomy for TRD from proliferative diabetic retinopathy were studied. 240 eyes in 203 patients met criteria for analysis (38 eyes were lost to follow up at 3 months; 68 at 12 months; 146 at 60 months). While most patients (nearly 80%) having TRD surgery had low vision pre-op, almost half attained VA that was > 20/80 five years post-op. Those most likely to achieve significant visual improvement (p < 0.0001) had concomitant vitreous hemorrhage pre-op. Only 6% of eyes met the US minimum driving standard before surgery based on VA compared to 28% after vitrectomy however this study did not examine visual fields which could warrant additional assessment depending on local requirements. In summary, significant gains in visual acuity are seen after vitrectomy for diabetic TRD that can result in functional improvement in activities of daily living.

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 Identification of Diagnostic and Prognostic microRNAs for Recurrent Vitreous Hemorrhage in Patients with Proliferative Diabetic Retinopathy

2019 ◽  
Vol 8 (12) ◽  
pp. 2217 ◽  
Author(s):  
Parviz Mammadzada ◽  
Juliette Bayle ◽  
Johann Gudmundsson ◽  
Anders Kvanta ◽  
Helder André
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage ◽  
Control Group ◽  
Ocular Tissues ◽  
Recurrent Hemorrhage ◽  
Pars Plana ◽  
And Control ◽  
Insight Into ◽  
Recurrent Vitreous Hemorrhage

MicroRNAs (miRNAs) can provide insight into the pathophysiological states of ocular tissues such as proliferative diabetic retinopathy (PDR). In this study, differences in miRNA expression in vitreous from PDR patients with and without incidence of recurrent vitreous hemorrhage (RVH) after the initial pars-plana vitrectomy (PPV) were analyzed, with the aim of identifying biomarkers for RVH. Fifty-four consented vitreous samples were analyzed from patients undergoing PPV for PDR, of which eighteen samples underwent a second surgery due to RVH. Ten of the sixty-six expressed miRNAs (miRNAs-19a, -20a, -22, -27a, -29a, -93, -126, -128, -130a, and -150) displayed divergences between the PDR vitreous groups and to the control. A significant increase in the miRNA-19a and -27a expression was determined in PDR patients undergoing PPV as compared to the controls. miRNA-20a and -93 were significantly upregulated in primary PPV vitreous samples of patients afflicted with RVH. Moreover, this observed upregulation was not significant between the non-RVH and control group, thus emphasizing the association with RVH incidence. miRNA-19a and -27a were detected as putative vitreous biomarkers for PDR, and elevated levels of miRNA-20a and -93 in vitreous with RVH suggest their biomarker potential for major PDR complications such as recurrent hemorrhage incidence.

Reasons for and Management of Postvitrectomy Vitreous Hemorrhage in Proliferative Diabetic Retinopathy

2010 ◽  
Vol 35 (4) ◽  
pp. 308-313 ◽  
Author(s):  
Hua Yan ◽  
Jing Cui ◽  
Yingjuan Lu ◽  
Jinguo Yu ◽  
Song Chen ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Vitreous Hemorrhage
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