Need for Vitreous Surgeries in Proliferative Diabetic Retinopathy in 10-Year Follow-Up: India Retinal Disease Study Group Report No. 2

Khan, Razaullah; Surya, Janani; Rajalakshmi, Ramachandran; Rani, Padmaja Kumari; Anantharaman, Giridhar; Gopalakrishnan, Mahesh; Sen, Alok; Desai, Abhishek; Roy, Rupak; Natarajan, Sundaram; Chen, Lanin; Chawla, Gajendra; Behera, Umesh Chandra; Gopal, Lingam; Muralidharan, Vinata; Sivaprasad, Sobha; Raman, Rajiv

doi:10.1159/000512767

Cited by 13 publications

(15 citation statements)

References 13 publications

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“…The standard of care for DME is anti-vascular endothelial growth factor (anti-VEGF) injections, which have been shown to be safe and effective in large pivotal clinical trials [11][12]. Accordingly, panretinal photocoagulation (PRP), anti-VEGF injections, or a combination of them are used today for the treatment of PDR [13][14][15][16] before ending up in advanced-stage disease, including vitreous hemorrhage (VH) and tractional retinal detachment (TRD) [10,17]. It is worthy to note that failure to visit clinicians and to undergo the appropriate treatment may result in worse outcomes and potential irreversible visual loss in patients with DR [18][19].…”

Section: Introductionmentioning

confidence: 99%

Effect of COVID-19-Associated Lockdown on Patients With Diabetic Retinopathy

Chatziralli¹,

Dimitriou²,

Kazantzis³

et al. 2021

Cureus

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To evaluate the effect of the coronavirus disease 2019 (COVID-19)-related lockdown in the management of patients with diabetic retinopathy (DR), including diabetic macular edema (DME), in a tertiary reference center in Greece. MethodsIn this retrospective study, we first compared the number of patients who were diagnosed with DR or DME in our clinic during the period of the lockdown and during the same period of the previous year. In addition, we included consecutive patients with DR or DME, who were followed up and treated regularly in our clinic and their appointments deferred due to lockdown, so as to compare the visual acuity, fundoscopy, and optical coherence tomography (OCT) findings prior to and post lockdown. ResultsDuring the lockdown period, there was a statistically significant decrease in patients with DR and DME as compared to the same period in the previous year. Regarding patients with previously diagnosed DME, there was a statistically significant worsening in their visual acuity and central retinal thickness after lockdown as compared to the last visit before lockdown (p<0.001 for both comparisons). Concerning patients diagnosed with DR and without DME before lockdown, 30% of patients with severe non-proliferative diabetic retinopathy (NDPR) and 8.3% of patients with quiescent proliferative DR (PDR) progressed to active PDR while four out of 107 patients (3.7%) developed DME during the lockdown. Multivariate regression analysis revealed that only the time interval between the last visit before lockdown and the first visit after the lockdown was associated with the best-corrected visual acuity (BCVA) change (p=0.017). ConclusionsThe COVID-19-related lockdown was related to the postponement in patient care, which resulted in significantly worse visual acuity outcomes in patients with DR.

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Section: Introductionmentioning

confidence: 99%

Effect of COVID-19-Associated Lockdown on Patients With Diabetic Retinopathy

Chatziralli¹,

Dimitriou²,

Kazantzis³

et al. 2021

Cureus

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“…Vote et al18 report that ∼38% fellow eyes of patients who underwent PPV for the presenting eye ultimately require PPV at a mean time of 1.6 years after primary eye surgery because of the development of vitreous hemorrhage, TRD, or combined tractional/rhegmatogenous retinal detachment, suggesting that early intervention may be preferable to waiting for end-stage disease. Even among patients with completed PRP, one-third will require PPV over a 10-year follow-up period 9. The protective effect of PPV against advancing disease has been demonstrated even when comparing the course of disease in a single patient who underwent PPV in 1 eye and medical management only in the fellow eye 43.…”

Section: Loss To Follow-up (Ltfu) and Consequences Of Treatment Inter...mentioning

confidence: 99%

“…Even among patients with completed PRP, one-third will require PPV over a 10-year follow-up period. 9 The protective effect of PPV against advancing disease has been demonstrated even when comparing the course of disease in a single patient who underwent PPV in 1 eye and medical management only in the fellow eye. 43 Taken together, this data suggests that PPV combined intraoperative endolaser may be a superior option to both PRP or anti-VEGF treatment alone for PDR patients at high risk for LTFU.…”

Section: Loss To Follow-up (Ltfu) and Consequences Of Treatment Inter...mentioning

confidence: 99%

Medical Versus Surgical Management of Proliferative Diabetic Retinopathy: A Review of Current Treatments, Efficacy, Cost-effectiveness, and Compliance-related Outcomes

Engelhard¹,

Kovacs²,

Kiss³

2022

International Ophthalmology Clinics

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outcomes, potential complications, the necessity of additional treatments, cost-effectiveness, and quality of life considerations. ' Treatment OutcomesThe Diabetic Retinopathy Study (DRS) established PRP as the standard of care for the treatment of PDR. 2 The DRS and the Early Treatment Diabetic Retinopathy Study (ETDRS) demonstrated a ∼50% reduction in the rate of severe vision loss (defined as 5/200 vision or worse at 2 or more consecutive 4-mo follow-up visits) in PDR for patients who received PRP. 3,4 However, despite these successes, 5% of patients ultimately develop complications requiring PPV even after full PRP treatment. 5,6 Among patients in the Diabetic Retinopathy Clinic Research Network (DRCR) Protocol S study, 45% of PRP-treated eyes required additional PRP over 2 years of follow-up, and 19% required PPV over 5 years of follow-up. 7,8 Khan et al 9 reported that over 10 years of followup, 89% of treated eyes required additional PRP, one-third required retinal surgery, and 16% required intravitreal anti-VEGF treatment. It is clear from this data that although PRP provides relatively good outcomes in the short term and medium term, over a long-enough follow-up period, the majority of patients treated with PRP ultimately do require additional interventions. This risk is further magnified in eyes with PDR with associated hemorrhage or traction, in whom rates of required PPV within 1 to 2 years were higher than in patients with uncomplicated PDR alone. 10 PRP treatment is also associated with peripheral visual field loss, declines in contrast sensitivity, exacerbations in diabetic macular edema (DME), and pain. 7,[11][12][13] Fong et al 14 reported that of patients treated with PRP, up to 50% had some degree of visual field abnormality, 38% had worsened color vision, 38% reported worsened night driving, and 60% had worsened dark adaptation. It is worth noting, however, that the initial trials involved specific laser settings, which may not reflect how laser is conducted in current clinical practice.Intravitreal injection of anti-VEGF agents has become an increasingly popular alternative to or adjuvant for PRP. DRCR Protocol S demonstrated the noninferiority of intravitreal ranibizumab to PRP for the treatment of PDR in both the 2-and 5-year analyses. 7,8 Furthermore, the ranibizumab group had lower rates of development of vision-threatening DME and had less visual field loss than the PRP group. 8 In eyes without baseline DME, the 5-year cumulative probability of developing visionthreatening DME was 22% in the ranibizumab group and 38% in the PRP group, and the rate of retinal detachment at 5 years was 7% in the ranibizumab group versus 18% in the PRP group. PPV was performed in 15% and 22% of eyes in the ranibizumab and PRP groups respectively. Rates of development of iris neovascularization and neovascular glaucoma 4 ' Engelhard et al

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“…Despite the fact that there are many hospitals and eye clinics in India's cities, the doctor-to-patient ratio remains low. There is a paucity of both infrastructure and ophthalmologists in rural locations [2]. Even community outreach activities are hampered by a lack of qualified professionals in remote locations to appropriately assess patients.…”

Section: Introductionmentioning

confidence: 99%

Identification of Retinal Disease using Anchor-Free Modified Faster Region

Arulselvam.¹,

Joseph²

2022

IJACSA

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Infections of the retinal tissue, as well as delayed or untreated therapy, may result in visual loss. Furthermore, when a large dataset is involved, the diagnosis is prone to inaccuracies. As a consequence, a completely automated model of retinal illness diagnosis is presented to eliminate human input while maintaining high accuracy classification findings. ODALAs (Optimal Deep Assimilation Learning Algorithms) are unable to handle zero errors or covariance or linearity and normalcy. DLTs (Deep Learning Techniques) such as GANs (Generative Adversarial Networks) or CNNs might replace the numerical solution of dynamic systems (Convolution Neural Networks), in order to speed up the runs. With this objective, this study proposes a completely automated multi-class retina disorders prediction system in which pictures from the Fundus image dataset are upgraded using RSWHEs (Recursive Separated Weighted Histogram Equalizations) to boost contrast and noise is eliminated using the Wiener filter. The improved picture is used for segmentation, which is done using clustering and the optimum threshold. The suggested EFFCM is used for clustering (Enriched Fast Fuzzy C Means). The suggested AOO (Adaptive optimum Otsu) threshold technique is used for clustering and picture optimal thresholding. This work suggests AMF-RCNNs (anchor-free modified faster region-based CNNs) that integrate AFRPNs (anchor free regions proposal generation networks) with Improved Fast R-CNNs into single networks for detecting retinal issues accurately. The performances of Accuracy is 98.5%, F-Measure is 96.5%, Precession is 99.2% and different Subset features are 98.5 % show better results when compared with other related techniques or models.

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Need for Vitreous Surgeries in Proliferative Diabetic Retinopathy in 10-Year Follow-Up: India Retinal Disease Study Group Report No. 2

Cited by 13 publications

References 13 publications

Effect of COVID-19-Associated Lockdown on Patients With Diabetic Retinopathy

Effect of COVID-19-Associated Lockdown on Patients With Diabetic Retinopathy

Medical Versus Surgical Management of Proliferative Diabetic Retinopathy: A Review of Current Treatments, Efficacy, Cost-effectiveness, and Compliance-related Outcomes

Identification of Retinal Disease using Anchor-Free Modified Faster Region

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