Intravitreal aflibercept for rubeosis iridis secondary to proliferative diabetic retinopathy

Weng, Shao-Wei; Huang, Tzu-Lun; Su, Pei–Yuan; Chang, Po‐Yuan; Wang, Jia-Kang

doi:10.21037/jes.2016.04.16

Cited by 2 publications

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“…It is well-known that iris neovascularization (NVI) starts from the pupil margin where aqueous humor touches it the most. [11][12][13] Thickening at the first 1 mm can be accounted for with this mechanism. Many studies show that maculopathy and neovascularization in the DR are triggered by the release of various inflammatory cytokines.…”

Section: Discussionmentioning

confidence: 98%

Iris thickness measurements in patients with diabetic retinopathy

Demirtaş

Pekel

et al. 2020

European Journal of Ophthalmology

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Purpose: The aim of the study was to investigate iris alterations in diabetic retinopathy (DR). Methods: Sixty-nine eyes of 69 patients were recruited and three groups of patients were examined: proliferative DR ( n = 25), non-proliferative DR ( n = 21) and healthy controls ( n = 23). Macular optical coherence tomography (OCT), anterior segment iris OCT, and slit lamp digital camera photographs were taken. The thicknesses of the iris at a distance of 1 mm, 2 mm, and 3 mm from pupil margin were measured via iris OCT. Iris crypt count, furrow extent, color tone and collarette/diameter ratio were measured by means of anterior segment photography. Visual acuity, refractive error, intraocular pressure, and numbers of intravitreal injections were also recorded. Results: The iris thickness measurements at 1 mm from pupil margin were significantly correlated with the macular thickness measurements ( r = 0.32, p = 0.016). In the proliferative DR group, total number of injections were significantly correlated with the iris thickness measurements at 1 mm ( r = 0.25, p = 0.04). The iris thickness measurements at distances 1 mm, 2 mm, and 3 mm from the pupil margin were similar in all of the groups ( p > 0.05). Iris thickness did not correlate with age, intra-ocular pressure and collarette iris ratio in all the participants ( p > 0.05). Conclusion: Iris thickness is similar in diabetic patients and healthy controls. Meanwhile, iris thickness near the pupillary margin is positively correlated with macular thickness.

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Section: Discussionmentioning

confidence: 98%

Iris thickness measurements in patients with diabetic retinopathy

Demirtaş

Pekel

et al. 2020

European Journal of Ophthalmology

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“…Chen et al 23 reported that three monthly intravitreal aflibercept injections yielded benefits in nearly two-thirds of cases of DME resistant to bevacizumab or ranibizumab over a short-term follow-up. IVA has been observed to be safe and effective in submacular hemorrhage secondary to neovascular AMD, 24 in resolving rubeosis iridis secondary to proliferative diabetic retinopathy with VH, 25 and in macular edema secondary to central retinal vein occlusion. 26 IVA has been tested in multiple retinal diseases; however, specific literature regarding its safety and efficacy in VH due to diabetic retinopathy is lacking.…”

Section: Discussionmentioning

confidence: 99%

Determining the Superiority of Vitrectomy vs Aflibercept for Treating Dense Diabetic Vitreous Hemorrhage: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Quiroz-Gonzalez¹,

QUIROZ-GONZALEZ²,

Lima-Gómez³

2023

OPTH

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This review aimed to systematically compare the efficacy and safety of intravitreal aflibercept (IVA) and vitrectomy for treating severe vitreous hemorrhage (VH) secondary to proliferative diabetic retinopathy (PDR). The review was conducted in accordance with PRISMA guidelines. A search strategy, including the MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and US National Library of Medicine databases, was developed to identify randomized controlled trials (RCTs) that compared vitrectomy and IVA for managing VH due to PDR (participant age ≥ 18 years). The primary outcome measure was the difference in the mean visual acuity between the two treatment groups at 1, 6, and 24 months. Outcome measures included clearance of VH (in weeks), the incidence of recurrent VH, and the rate of complications. The studies were evaluated using the Cochrane Bias (ROB) tool. We identified 774 articles; six articles met the inclusion criteria, and two were ultimately included (n = 239 eyes). With or without PRP, IVA injections and vitrectomy were performed in 117 and 122 eyes, respectively. The mean BCVA at one month was significantly better in the vitrectomy group (MD=0.22, CI:0.10–0.34, p=0.0003), but no difference was found at six months (MD=0.04, CI: −0.04–0.12, p=0.356). The incidence of recurrent VH was significantly higher in the IVA group (OR=5.05, CI:2.71–9.42, p<0.0001). The probability of recurrent VH was five times greater in the IVA group than that in the vitrectomy group. There were no significant differences in the overall proportions of intra- or postoperative complications (OR=0.64, CI: 0.09–4.85, p=0.669). None of the studies had a low ROB in any of the seven domains. We conclude that IVA can be considered a viable treatment modality for diabetic VH in patients with a good follow-up. Vitrectomy initially provides better visual effect, faster VH recovery, and lower VH recurrence than IVA injections.

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Intravitreal aflibercept for rubeosis iridis secondary to proliferative diabetic retinopathy

Cited by 2 publications

References 0 publications

Iris thickness measurements in patients with diabetic retinopathy

Iris thickness measurements in patients with diabetic retinopathy

Determining the Superiority of Vitrectomy vs Aflibercept for Treating Dense Diabetic Vitreous Hemorrhage: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

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