Preoperative Bevacizumab Administration in Proliferative Diabetic Retinopathy Patients Undergoing Vitrectomy: A Randomized and Controlled Trial Comparing Interval Variation

Castillo, Javier G.; Aleman, Isaac; Rush, Sloan W; Rush, Ryan B

doi:10.1016/j.ajo.2017.08.013

Cited by 43 publications

(43 citation statements)

References 26 publications

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“…We choose these factors from age, sex and factors show significant differences between two groups in Table (diabetic duration, baseline logMAR, simple VH, TRD), Table (air tamponade) and preoperative anti‐VEGF that previous reports shown the efficiency for reducing postoperative complications in PDR eyes (Castillo et al. ; Feng et al. ), and the outcomes were shown in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…) and 9.6% (Castillo et al. ), and another report using 25‐gauge MIVS needed vitrectomy in 12% (Farouk et al. ).…”

Section: Discussionmentioning

confidence: 96%

“…Second, we injected anti‐VEGF 2–3 days before the surgery, but it is reportedly best to inject intravitreal anti‐VEGF 5–10 days or 7 days before vitrectomy (Castillo et al. ; Feng et al. ).…”

Section: Discussionmentioning

confidence: 99%

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Prognostic factors of revitrectomy for complications in eyes with proliferative diabetic retinopathy: a retrospective multicentre study

Takayama

Someya

Yokoyama

et al. 2019

Acta Ophthalmologica

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Purpose: To identify prognostic factors for revitrectomy in patients who underwent vitrectomy for complications with proliferative diabetic retinopathy (PDR) in multicentre study. Methods: Consecutive 452 eyes of 452 patients with PDR undergoing 25-gauge microincision vitrectomy system (MIVS) in seven centres were retrospectivity reviewed. Preoperative ocular factors (baseline visual acuity [VA], vitreous haemorrhage [VH], tractional retinal detachment [TRD] and retinal photocoagulation), general factors (sex, age, diabetes duration, HbA1c level, hypertension, anticoagulant medication and estimated glomerular filtration rate), surgical procedures (preoperative anti-vascular endothelial growth factor injection, internal limiting membrane peeling, combined cataract surgery, retinal break, and tamponade), postoperative complications for revitrectomy and postoperative VA at 6 months were evaluated. Results: In the follow-up period of 6 months, revitrectomy was performed in 56 eyes (26.3%), and postoperative complications for revitrectomy were VH in 31 eyes (15%), TRD in 13 eyes (6.2%) and membrane proliferation in 12 eyes (5.2%). The mean LogMAR improvement from baseline to 6 months in revitrectomy group (0.39) was significantly worse than in single vitrectomy group (0.74). Diabetic duration, low baseline VA, less simple VH, TRD and air tamponade were statistical risk factors of revitrectomy, and logistic regression analysis identified low baseline VA and air tamponade also as prognostic factors of revitrectomy. Conclusion: Our results indicated that prognosis of VA was worse in PDR patients with revitrectomy and low baseline VA and air as the tamponade material were the potential prognostic factors of revitrectomy.

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Section: Resultsmentioning

confidence: 99%

“…) and 9.6% (Castillo et al. ), and another report using 25‐gauge MIVS needed vitrectomy in 12% (Farouk et al. ).…”

Section: Discussionmentioning

confidence: 96%

See 1 more Smart Citation

Prognostic factors of revitrectomy for complications in eyes with proliferative diabetic retinopathy: a retrospective multicentre study

Takayama

Someya

Yokoyama

et al. 2019

Acta Ophthalmologica

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“…[192][193][194] With regards to the use of preoperative anti-VEGF therapy to minimize intraoperative and postoperative hemorrhages, the majority of studies do demonstrate a benefit. [195][196][197][198][199][200][201][202] In addition, reduction in operating time and a trend toward better postoperative VA have also been demonstrated in smaller case series. 181,[203][204][205] Initial concerns regarding the potential adverse effect of vitrectomy on the durability of intravitreally administered anti-VEGF agents have not been borne out by recent studies.…”

Section: Surgical Management Of Diabetic Retinopathy and Diabetic Macmentioning

confidence: 99%

<p>The Evolving Treatment of Diabetic Retinopathy</p>

Mansour¹,

Browning²,

Wong³

et al. 2020

OPTH

151

119

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Purpose: To review the current therapeutic options for the management of diabetic retinopathy (DR) and diabetic macular edema (DME) and examine the evidence for integration of laser and pharmacotherapy. Methods: A review of the PubMed database was performed using the search terms diabetic retinopathy, diabetic macular edema, neovascularization, laser photocoagulation, intravitreal injection, vascular endothelial growth factor (VEGF), vitrectomy, pars plana vitreous surgery, antiangiogenic therapy. With additional cross-referencing, this yielded 835 publications of which 301 were selected based on content and relevance. Results: Many recent studies have evaluated the pharmacological, laser and surgical therapeutic strategies for the treatment and prevention of DR and DME. Several newer diagnostic systems such as optical coherence tomography (OCT), microperimetry, and multifocal electroretinography (mfERG) are also assisting in further refinements in the staging and classification of DR and DME. Pharmacological therapies for both DR and DME include both systemic and ocular agents. Systemic agents that promote intensive glycemic control, control of dyslipidemia and antagonists of the renin-angiotensin system demonstrate beneficial effects for both DR and DME. Ocular therapies include anti-VEGF agents, corticosteroids and nonsteroidal anti-inflammatory drugs. Laser therapy, both as panretinal and focal or grid applications continue to be employed in management of DR and DME. Refinements in laser devices have yielded more tissue-sparing (subthreshold) modes in which many of the benefits of conventional continuous wave (CW) lasers can be obtained without the adverse side effects. Recent attempts to lessen the burden of anti-VEGF injections by integrating laser therapy have met with mixed results. Increasingly, vitreoretinal surgical techniques are employed for less advanced stages of DR and DME. The development and use of smaller gauge instrumentation and advanced anesthesia agents have been associated with a trend toward earlier surgical intervention for diabetic retinopathy. Several novel drug delivery strategies are currently being examined with the goal of decreasing the therapeutic burden of monthly intravitreal injections. These fall into one of the five categories: non-biodegradable polymeric drug delivery systems, biodegradable polymeric drug delivery systems, nanoparticle-based drug delivery systems, ocular injection devices and with sustained release refillable devices. At present, there remains no one single strategy for the management of the particular stages of DR and DME as there are many options that have not been rigorously tested through large, randomized, controlled clinical trials. Conclusion: Pharmacotherapy, both ocular and systemic, will be the primary mode of intervention in the management of DR and DME in many cases when cost and treatment burden are less constrained. Conventional laser therapy has become a secondary intervention in these instances, but remains a first-line option when cost and ...

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“…Severe vision impairment with proliferative diabetic retinopathy (PDR) frequently results from complications due to neovascularization and fibrovascular proliferation [1]. Non-clearing vitreous hemorrhage, tractional retinal detachment (TRD), extensive fibrovascular proliferation are common indications for vitrectomy in patients with PDR [2,3].…”

Section: Introductionmentioning

confidence: 99%

Ghost cell glaucoma after intravitreous injection of ranibizumab in proliferative diabetic retinopathy

Zhang

Zhao

et al. 2019

Preprint

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BACKGROUND: Intravitreous injection of anti-vascular endothelial growth factor agents has been widely used as an adjunctive method to vitrectomy in eyes with vitreous hemorrhage due to proliferative diabetic retinopathy (PDR). Here we reported a series of patients with PDR who developed ghost cell glaucoma after intravitreous injection and analyzed the potential factors that might be related to the development of ghost cell glaucoma. METHODS: Retrospective case series study. A total of a consecutive 71 eyes of PDR patients who received vitrectomy after intravitreous injection of ranibizumab (IVR) from January 2015 to January 2017 were enrolled in the study.Intraocular pressure (IOP) was recorded before and after intravitreous injection. Medical records of patients were recorded and investigated. The onset and treatment of ghost-cell glaucoma were recorded. RESULTS: There were 8 out of 71 eyes of the PDR patients developed ghost cell glaucoma after they received IVR. The interval between detection of elevation of IOP and intravitreous injection ranged from 0 to 2 days. There were 2 eyes had IOP greater than 30mmHg at the first IOP measurement at 30 minutes after IVR and remained elevated thereafter. The mean maximum IOP was 46.5±8.0 mmHg. There were 5 patients required medicine and 3 patients required additional paracentesis to control IOP. All patients gained normal IOP after vitrectomy and did not require medicine for lowering IOP ever since. The binary backward stepwise logistic regression model showed that the presence of ghost cell glaucoma was associated with tractional retinal detachment (RR= 4.60 [2.02~8.48], p= 0.004) and fibromembrane involving disk (RR=-3.57 [-7.59~-0.92], p=0.03) (AIC= 39.23，AUC=0.88). CONCLUSION: The ghost cell glaucoma can occur after IVR among PDR patients who are required vitrectomy. Attention on postoperative IOP should be paid to patients with PDR undergoing vitrectomy who receive a preoperative intravitreous injection of anti-VEGF agents, especially in patients with severe PDR.

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Preoperative Bevacizumab Administration in Proliferative Diabetic Retinopathy Patients Undergoing Vitrectomy: A Randomized and Controlled Trial Comparing Interval Variation

Cited by 43 publications

References 26 publications

Prognostic factors of revitrectomy for complications in eyes with proliferative diabetic retinopathy: a retrospective multicentre study

Prognostic factors of revitrectomy for complications in eyes with proliferative diabetic retinopathy: a retrospective multicentre study

<p>The Evolving Treatment of Diabetic Retinopathy</p>

Ghost cell glaucoma after intravitreous injection of ranibizumab in proliferative diabetic retinopathy

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