A Comparison of Immediate and Delayed Vitrectomy for the Management of Vitreous Hemorrhage due to Proliferative Diabetic Retinopathy

Fassbender, Janelle M.; Özkök, Ahmet; Canter, Hannah; Schaal, Shlomit

doi:10.3928/23258160-20151214-05

Cited by 14 publications

(19 citation statements)

References 22 publications

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“…The study shows the result that immediate vitrectomy with endolaser shortens the time of visual loss of patient and reduces the need for additional PRP laser. 14 In this research, on most of RRD cases (70.6%), vitrectomy was performed less than one month. Vitreous hemorrhage with RRD suspicion required immediate vitrectomy action.…”

Section: Discussionmentioning

confidence: 91%

Surgical Approach In Vitreous Hemorrhage

et al. 2017

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Introduction: To report cases of retinal disorders that cause vitreous hemorrhage and the timing of pars plana vitrectomy in Cicendo Eye Hospital Methods: Retrospective observational study of all patients diagnosed with the vitreous hemorrhage who had undergone pars plana vitrectomy in 2016. Data were collected from medical record. Result: The mean age of this study is 54.65 years old from 260 vitreous hemorrhage patients. The most common retinal abnormalities are proliferative diabetic retinopathy (49.6%), wet age related macular degeneration (AMD) (13.5%), undetected retinal abnormalities (12.7%), retinal vein occlusion (8.8%), rhegmatogen retinal detachment (6.5%), trauma (3.45%), vasculitis (3.1%), idiopathic polypoidal choroidal vasculopathy (3.1%), and drop IOL (1.2%). PPV performed 1-3 months after initial assessment (31.25%), less than 1 month (13.2%), more than 3 months (14.6%) Conclusion: The most common etiology of vitreous hemorrhage is proliferative diabetic retinopathy. Pars plana vitrectomy was performed 1 – 3 months after an initial assessment of the patients.

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Section: Discussionmentioning

confidence: 91%

Surgical Approach In Vitreous Hemorrhage

et al. 2017

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“…In one series, the mean visual acuity improved from 20/600 preoperatively to 20/90 postoperatively [10]. Another study done by Fassbender et al, [19] showed that early vitrectomy for VH due to PDR significantly decreases time spent with vision loss.…”

Section: Discussionmentioning

confidence: 91%

Intravitreal Aflibercept injection with Panretinal photocoagulation versus early Vitrectomy for diabetic vitreous hemorrhage: randomized clinical trial

2020

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Background: To compare efficacy and safety of intravitreal aflibercept (IVA) injection with panretinal photocoagulation (PRP) versus early vitrectomy for diabetic vitreous hemorrhage (VH). Methods: Prospective, randomized study that included 34 eyes with diabetic VH. They were divided into two groups, Group Ι (17 eyes) received three successive IVA injections followed by PRP and group ΙΙ (17 eyes) for whom early vitrectomy was done. Follow up was carried out after one, two, three, six and nine months. The primary outcome measure was change in the mean best corrected visual acuity (BCVA) after nine months, secondary outcome measures were mean duration of clearance of VH and rate of recurrent hemorrhage with any additional treatment in both groups. Complications were reported.Results: There was no statistically significant difference regarding initial demographic criteria between both groups. The mean final log MAR BCVA was statistically better than the initial BCVA in both groups (0.51 ± 0.20, 1.17 ± 0.48 for group I and 0.48 ± 0.18, 1.44 ± 0.44 for group II, P < 0.001). There was no statistically significant difference between both groups regarding the mean final Log Mar BCVA (0.51 ± 0.20 for group I, 0.48 ± 0.18 for group II, p ≥ 0.05), the mean duration of clearance of VH was 7.8 ± 1.8 weeks, 5 days for group I and II respectively. PRP was completely done for all eyes in group I after three months. The difference in the recurrence rate between group I (29.4%) and group II (11.8%) was statistically significant (p < 0.05). Vitrectomy was done for three eyes (17.6%) due to recurrent non-resolving VH in group I. late recurrent VH occurred in two eyes (11.8%) in group II, IVA was given with complete clearance of the hemorrhage. No vision threatening complications were reported in both groups.Conclusion: Both intravitreal injection of aflibercept followed by PRP and early vitrectomy are effective and safe modalities for treatment of diabetic vitreous hemorrhage. Early vitrectomy leads to faster vision gain with less incidence of recurrence than intravitreal injection.

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“…A large number of literatures have reported that early vitrectomy is beneficial to the improvement of visual acuity and visual function [11][12][13] . Janelle et al [14] showed that the visual acuity of patients with vitreous hemorrhage who received vitrectomy within 30 days was significantly better than that of patients with delayed surgery. Our study showed that the best corrected visual acuity of the four groups at 1 month and 3 months after the operation was significantly higher than that before the operation.…”

Section: Discussionmentioning

confidence: 99%

Timing of optimal surgical intervention for vitreous hemorrhage in patients with proliferative diabetic retinopathy

Lin

Chen

Wang

et al. 2020

Preprint

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Background：To explore the optimal timing of vitrectomy for vitreous hemorrhage in the patients with proliferative diabetic retinopathy (PDR).Method：Seventy-six PDR patients (85 eyes) who were diagnosed with vitreous hemorrhage and received vitrectomy were retrospectively enrolled into this study. The patients were categorized into 4 groups based on the timing of surgical intervention after the occurrence of hemorrhage, namely Group 1 (less than 15 days, with 28 eyes of 27 patients), Group 2 (15~30 days, with 29 eyes of 27 patients), Group 3 (30~90 days, with 14 eyes of 11 patients) and Group 4 (>90 days, with 14 eyes of 11 patients). Best corrected visual acuity (BCVA) and central macular thickness (CMT) from OCT before and at 1 mo and 3 mo after operation were collected as the main outcomes. The postoperative complications were also reported.Result: 1) BCVA (logMAR): the mean pre-operation BCVA was not significantly different among the 4 groups (P=0.139), while the mean post-operation BCVA was significantly worse in groups with longer gap between the vitreous bleeding and the vitrectomy, both at 1m and 3m after surgery (P=0.043; P<0.001). 2) CMT(μm): Although CMT was unavailable to measure in most included eyes before surgery, the mean CMT was significantly thicker in groups with postponed surgical intervention both at 1-month (P=0.001) and at 3-month (P=0.006) after surgery. 3) Complications: No severe complications were spotted in early vitrectomy groups (Group 1 and Group 2) during the follow-up period. At 3 months after the operation, three cases of ocular hypertension and another case of neovascular glaucoma in Group 3 and 4 cases of ocular hypertension and another 3 cases of neovascular glaucoma in Group 4 were observed. Conclusion: Early vitrectomy is more effective in improving BCVA and decreasing CMT in the PDR patients with vitreous hemorrhage. Moreover, the post-operation complications were spotted less in early vitrectomy groups. Thus we suggested that vitrectomy should be performed early and better within one month after the onset of vitreous hemorrhage in PDR patients.

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A Comparison of Immediate and Delayed Vitrectomy for the Management of Vitreous Hemorrhage due to Proliferative Diabetic Retinopathy

Abstract: Immediate vitrectomy with endolaser for PDR-associated VH (< 30 days) decreases time spent with vision loss and the need for adjunctive PRP. Modern vitrectomy is safe and may be considered earlier in VH management.

Cited by 14 publications

References 22 publications

Surgical Approach In Vitreous Hemorrhage

Surgical Approach In Vitreous Hemorrhage

Intravitreal Aflibercept injection with Panretinal photocoagulation versus early Vitrectomy for diabetic vitreous hemorrhage: randomized clinical trial

Timing of optimal surgical intervention for vitreous hemorrhage in patients with proliferative diabetic retinopathy

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