Vitrectomy and Vitreoretinal Surgery in Persistent Macular Edema

2021 ◽  
pp. 341-349
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Inflammatory Diseases ◽  
Treatment Options ◽  
Vitreoretinal Surgery ◽  
Posterior Segment ◽  
Systemic Diseases ◽  
Ocular Diseases ◽  
Vein Occlusion ◽  
Common Causes

Macular edema can occur as a result of many ocular diseases and systemic diseases. Edema is associated with vascular leaking conditions. Diabetic retinopathy, retinal vein occlusion, posterior segment inflammatory diseases, and intraocular surgery are the most common causes. There are many treatment options in the treatment of edema. Despite medical and laser treatment, there may be persistent cases. Some of these cases can benefit from vitrectomy and vitreoretinal surgery. This review will focus on the place and applications of vitrectomy and vitreoretinal surgery in persistent macular edema.

Steroid Therapy in Diabetic Retinopathy and Diabetic Macular Edema

2018 ◽  
pp. 160-164
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vitreoretinal Surgery ◽  
Fluocinolone Acetonide ◽  
Intravitreal Triamcinolone ◽  
Intraocular Pressure Elevation ◽  
Risk Treatment ◽  
Therapeutic Alternatives ◽  
Endothelial Growth Factor

Diabetic macular edema (DME) is the leading cause of blindness in patients with diabetic retinopathy worldwide. Therapeutic alternatives now include focal/grid laser photocoagulation, vitreoretinal surgery, and intraocular injection of anti-angiogenic and steroid molecules. In patients with recalcitrant DME, especially in those cases when anti-vascular endothelial growth factor (VEGF) agents are contraindicated or a treatment regimen with fewer intravitreal injections is required, intravitreal administration of steroids represents a fundamental alternative. Three intravitreal corticosteroid options for DME treatment are currently available including the dexamethasone delivery system, the fluocinolone acetonide insert, and off-label intravitreal triamcinolone acetonide. All of these drugs are associated with the risk of cataract progression and intraocular pressure elevation. In patients unresponsive to anti-VEGF therapy, pseudophakic, at low risk for glaucoma, or who have significant cardiovascular risk, treatment with long-lasting intraocular steroids is suggested.

scholarly journals Nutraceuticals for the Treatment of Diabetic Retinopathy

Nutrients ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 771 ◽  
Author(s):  
Maria Grazia Rossino ◽  
Giovanni Casini
Keyword(s):  
Diabetic Retinopathy ◽  
Molecular Mechanisms ◽  
Treatment Options ◽  
Vitreoretinal Surgery ◽  
In Vivo Studies ◽  
Early Diabetes ◽  
Advanced Stages ◽  
Endothelial Growth Factor

Diabetic retinopathy (DR) is one of the most common complications of diabetes mellitus and is characterized by degeneration of retinal neurons and neoangiogenesis, causing a severe threat to vision. Nowadays, the principal treatment options for DR are laser photocoagulation, vitreoretinal surgery, or intravitreal injection of drugs targeting vascular endothelial growth factor. However, these treatments only act at advanced stages of DR, have short term efficacy, and cause side effects. Treatment with nutraceuticals (foods providing medical or health benefits) at early stages of DR may represent a reasonable alternative to act upstream of the disease, preventing its progression. In particular, in vitro and in vivo studies have revealed that a variety of nutraceuticals have significant antioxidant and anti-inflammatory properties that may inhibit the early diabetes-driven molecular mechanisms that induce DR, reducing both the neural and vascular damage typical of DR. Although most studies are limited to animal models and there is the problem of low bioavailability for many nutraceuticals, the use of these compounds may represent a natural alternative method to standard DR treatments.

scholarly journals The Evolving Treatment Options for Diabetic Macular Edema

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Atul Jain ◽  
Neeta Varshney ◽  
Colin Smith
Keyword(s):  
Diabetic Retinopathy ◽  
Visual Impairment ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vision Loss ◽  
Treatment Options ◽  
Previous Treatment ◽  
Common Cause ◽  
Working Age

Diabetic retinopathy (DR) is the leading cause of vision loss in working-age adults, and diabetic macular edema (DME) is the most common cause of visual impairment in individuals with DR. This review focuses on the pathophysiology, previous treatment paradigms, and emerging treatment options in the management of DME.

Laser Applications in Branch Retinal Vein Occlusion and Macular Edema

2019 ◽  
pp. 112-119
Keyword(s):  
Macular Edema ◽  
Laser Therapy ◽  
Retinal Vein Occlusion ◽  
Branch Retinal Vein Occlusion ◽  
Treatment Options ◽  
Combined Treatment ◽  
Primary Treatment ◽  
Laser Applications ◽  
Vein Occlusion ◽  
Major Branch

Branch retinal vein occlusion (BRVO) includes occlusion of major branch retinal vein, macular branch vein, and peripheral branch vein. BRVO is the second most common retinal vascular disease after diabetic retinopathy. Macular edema is the leading cause of visual loss related to BRVO. Although there are many treatment options, effective treatment applications are limited. Laser therapy is one of these applications; that is used both in the development of neovascularization and in the presence of macular edema. Grid laser therapy doesn’t take place as much as the former in the primary treatment of macular edema; that still continues efficiency in combined treatment and selected cases.

scholarly journals Early vitrectomy for dense vitreous hemorrhage in adults with non-traumatic and non-diabetic retinopathy

2017 ◽  
Vol 45 (6) ◽  
pp. 2065-2071 ◽  
Author(s):  
Ting Zhang ◽  
Jingjing Zhang ◽  
Xiaolei Sun ◽  
Jingyi Tian ◽  
Weiyun Shi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Diabetic Retinopathy ◽  
Retinal Vasculitis ◽  
Vitreous Hemorrhage ◽  
Complication Rates ◽  
Retinal Tear ◽  
Early Vitrectomy ◽  
Vein Occlusion ◽  
Common Causes ◽  
Mean Time

Objective To evaluate the etiologies for dense vitreous hemorrhage in adults with non-traumatic and reveal management of early vitrectomy for the disease. Methods Study included 105 eyes from 105 patients. Outcome measures were etiologies of vitreous hemorrhage, formation of retinal and/or disk neovascular membrane (NVM), incidence of retinal tear and detachment, visual acuity (VA) and postoperative complications. Results Mean time between presentation and surgery was 7.1 days. The most common etiologies were retinal vein occlusion (RVO) (58.1%), retinal tear (22.9%) and retinal vasculitis (10.4%). Most RVO (77.0%) and retinal vasculitis (72.7%) eyes were associated with retinal and/or disk NVM. Retinal tear and retinal detachment was found in 24 and 48 eyes, respectively. VA improved significantly from 1/70 to 0.6 following vitrectomy. The most common postoperative complication was cataract (28.6%). Conclusion RVO, retinal tear and retinal vasculitis were the most common causes of dense vitreous hemorrhage. Early vitrectomy has a good outcome with acceptable complication rates in this setting.

scholarly journals Prevalence of Posterior Segment Disease in Subjects Screened for Cataract- A Retrospective Study

2020 ◽  
Author(s):  
Gayatri Ravulaparth ◽  
Sravanthi Singarapu ◽  
Sathya Vattikonda ◽  
Gogineni Sahitya
Keyword(s):  
Diabetic Retinopathy ◽  
Visual Impairment ◽  
Retinal Vein Occlusion ◽  
Posterior Segment ◽  
Routine Screening ◽  
Care Hospital ◽  
Fundus Examination ◽  
Vein Occlusion ◽  
Increased Risk ◽  
Iop Measurement

Introduction: Glaucoma, retinal vein occlusion and diabetic retinopathy are the common posterior segment diseases affecting the eye and need to be specifically looked for in the community by Intra Ocular Pressure (IOP) measurement and a dilated fundus examination. Cataract screening alone in eye camps might not be adequate to prevent and treat these causes of blindness. Aim: To establish the need for routine screening of posterior segment diseases at primary and secondary eye care level by estimating the prevalence of this diseases in patients presenting with cataract in order to prevent avoidable blindness. Materials and Methods: This was a retrospective observational study conducted at Tertiary Care Hospital comprising of 1109 subjects who were screened for cataract and underwent cataract surgery, at screening camps from semi urban and rural localities in and around Hyderabad city between October 2018-March 2019. All subjects underwent detailed ophthalmic evaluation including visual acuity assessment, applanation tonometry, slit lamp examination and dilated fundus examination. Prevalence of blindness and moderate to severe visual impairment caused by posterior segment disease among these patients was analysed. Percentage distribution of the data was calculated mathematically. Results: Of the 1109 subjects, posterior segment diseases causing blindness was seen in 0.63%, severe visual impairment in 0.99% and moderate visual impairment in 3.78%. Glaucomatous optic neuropathy was the most common posterior segment disease followed by retinal vein occlusion and diabetic retinopathy in that order. Diabetes Mellitus (DM) and Hypertension (HTN) were associated with increased risk of glaucoma. Conclusion: Routine screening for posterior segment disease is recommended with the use of portable fundus cameras in the elderly population along with IOP measurement using hand held portable tonometer in screening camps in order to reduce the burden of avoidable blindness. Monitoring of life style diseases like HTN and DM at the time of cataract screening is needed for primary prevention of most of these diseases of the eye.

scholarly journals Ranibizumab Treatment and Protocols in Diabetic Retinopathy and Diabetic Macular Edema

2018 ◽  
pp. 143-146
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Treatment Efficacy ◽  
Combined Treatment ◽  
Optimal Dose ◽  
Intravitreal Ranibizumab ◽  
Anti Vegf ◽  
Common Causes ◽  
Ranibizumab Treatment

Diabetic macular edema (DME) is one of the most common causes of visual loss in patients with diabetic retinopathy (DRP). The prognosis of central involved diabetic macular edema has improved after anti-VEGF treatments. Intravitreal ranibizumab was the first anti-VEGF agent approved by the FDA for the treatment of diabetic macular edema. Despite the fact that it is a pathogenic treatment, it has brought some challenging situations on its own. In most studies, optimal dose and combined treatment were evaluated in terms of treatment efficacy. Recent studies revealed that ranibizumab treatment is effective in DRP and proliferative DRP regression as well as in diabetic macular edema treatment. In this article, we aimed to review the effects of Ranibizumab treatment on visual acuity, central macular thickness in patients with diabetic retinopathy, and diabetic macular edema through studies.

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