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

Takayama, Kei; Someya, Hideaki; Yokoyama, Hiroshi; Kimura, Takeshi; Takamura, Yoshihiro; Morioka, Masakazu; Sameshima, Seiji; Ueda, Takahiro; Ogata, Nahoko; Kitano, Shigehiko; Tashiro, Maki; Sugimoto, Masahiko; Kondo, Mineo; Sakamoto, Taiji; Takeuchi, Masaru

doi:10.1111/aos.14292

Cited by 9 publications

(26 citation statements)

References 35 publications

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“…The poor VA outcome was known to be related to macular-involved TRD, incomplete PRP, severe neovascular elsewhere (NVE), the presence of NVI, tRD involving discs, poor pre-PPV VA, and the combination of tRD and a retinal tear 34 . The condition of high-risk PDR and the combination of retinal tears (32.9%, 39.7%) were similar in the two groups.…”

Section: Discussionmentioning

confidence: 99%

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Ocular findings, surgery details and outcomes in proliferative diabetic retinopathy patients with chronic kidney disease

Chandra

Liu

et al. 2022

Preprint

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Purpose: We investigated the influence of impaired renal function on fundus characteristics, pars-plana vitrectomy (PPV) details, and outcomes in patients with proliferative diabetic retinopathy (PDR). Design: a retrospective cohort study Methods: We investigated a consecutive series of PDR patients who underwent PPV. The diabetic complications, previous photocoagulation, intravitreal injections before PPV, ocular findings during PPV, surgical details, short-term visual outcome and post-PPV complications were recorded and compared between patients with and without impaired renal function. Results: 149 patients had normal renal function (67.7%) and 71 (32.3%) patients had impaired renal function, 85.4% of patients were identified with chronic kidney disease (CKD) during the preoperative assessment. Impaired renal function was related to hypertension (3.40[1.58-7.29], p=0.002), incomplete panretinal photocoagulation (PRP) (3.18[1.50-6.72], p=0.002), severe fibrovascular membrane (8.19[3.43-19.54], p<0.001), and extensive retinal vascular closure (3.40[1.54-7.52], p=0.002). There was a more frequent occurrence of severe intraoperative bleeding (56.3%, 32.2%, p=0.001), a higher percentage of intraocular subretinal fluid drainage (45.1%, 22.1%, p=0.008) in patients with impaired renal function. The percentage of patients whose visual acuity (VA) increased was similar between two groups (46.4%, 54.3%, p=0.34) . Conclusions: In PDR patients, screening for CKD was required before PPV. PDR patients with impaired renal function tended to have more severe ischemic retinal conditions. Comparable PPV outcomes could be obtained in patients with and without impaired renal damage.

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Section: Discussionmentioning

confidence: 99%

Section: Impacts Of Ckd On Ppv and Outcomesmentioning

confidence: 99%

Ocular findings, surgery details and outcomes in proliferative diabetic retinopathy patients with chronic kidney disease

Chandra

Liu

et al. 2022

Preprint

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“…Written informed consent was waived by the ethics committees due to the retrospective nature of the study, but all subjects were informed of the study. The study methods were developed in accordance with the relevant guidelines and regulations, and have been reported previously [27][28][29]. Some of the data in this report were also used in other studies [27][28][29].…”

Section: Methodsmentioning

confidence: 99%

“…The study methods were developed in accordance with the relevant guidelines and regulations, and have been reported previously [27][28][29]. Some of the data in this report were also used in other studies [27][28][29].…”

Section: Methodsmentioning

confidence: 99%

Potential bias of preoperative intravitreal anti-VEGF injection for complications of proliferative diabetic retinopathy

et al. 2021

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Purpose Intravitreal anti-VEGF injection (IVI) is administered before vitrectomy to assist management of proliferative diabetic retinopathy (PDR)-related complications. In the clinical setting, retinal surgeons determine the use of preoperative IVI based on individual criteria. In this study, we investigated factors related to the potential bias of retinal surgeons in using IVI prior to vitrectomy for PDR-related complications, and evaluated the real-world outcomes of surgeon-determined preoperative IVI. Methods Medical records of 409 eyes of 409 patients who underwent 25-gauge vitrectomy for PDR complications at seven Japanese centers (22 surgeons) were retrospectively reviewed. Ocular factors, demographic and general clinical factors, surgical procedures, and postoperative complications were compared between IVI group (patients who received preoperative IVI; 87 eyes, 21.3%) and non-IVI group (patients who did not receive preoperative IVI; 322 eyes, 78.7%). In addition, baseline HbA1c in IVI group and non-IVI group was compared between eyes with and without postoperative complications. Results At baseline, IVI group was younger (P<0.001), had shorter duration of diabetes treatment (P = 0.045), and higher frequencies of neovascular glaucoma [NVG] (P<0.001) and tractional retinal detachment [TRD] (P<0.001) compared to non-IVI group. Although IVI group had higher frequencies of intraoperative retinal break and tamponade procedure, there were no significant differences in postoperative complications and additional treatments between two groups. Baseline HbA1c levels were also not correlated with postoperative complications of VH, NVG, and RD both in IVI group and non-IVI group. Logistic regression analysis identified age (P<0.001, odds ratio [OR] 0.95), presence of NVG (P<0.001, OR 20.2), and presence of TRD (P = 0.0014, OR 2.44) as preoperative factors in favor of IVI. Conclusions In this multicenter real-world clinical study, younger age and presence of NVG and TRD were identified as potential biases in using IVI before vitrectomy for PDR complications. Eyes that received preoperative IVI had more intraoperative retinal breaks requiring tamponade than eyes not receiving IVI, but postoperative outcome was not different between the two groups.

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“…NPDR occurs when the blood vessels in retina are damaged and start to leak fluid outside the blood vessels, causing the retina to become moist and swollen [17] . In order to prevent vision loss, the current treatment mainly uses laser treatment and surgical removal of vitreous gel (vitrectomy) to improve vision [18,19] . Although effective, the current laser and surgical treatment is still limited by high treatment burden, many ocular adverse reactions and unclear mechanism.…”

mentioning

confidence: 99%

Analysis of the Clinical Efficacy of Minocycline in the Treatment of Diabetic Retinopathy

Song¹,

Rong²,

Tang³

et al. 2021

IJPS

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Song et al.: Minocycline Efficacy in the Treatment of Diabetic Retinopathy Minocycline has been proven to reduce oxidative stress. This article further explores the safety and clinical efficacy of minocycline in the treatment of diabetic retinopathy. Selected 60 patients with diabetic retinopathy admitted to our hospital and divided them into two groups, observation group (30 cases) and control group (30 cases) randomly. Both groups received conventional treatment. Then treated control group with calcium dobesilate capsule and rosuvastatin calcium tablet. As well as the same drugs in control group, observation group received minocycline and the treatment period was 60 d. Compared visual acuity score, diabetic retinopathy stage, retinal neovascularization fluorescein leakage area, incidence of complications and adverse drug reactions with both groups after treatment. The vision improvement of observation group was remarkably higher than control group (p<0.05); The incidence of retinopathy stage III in control group was 36.7 %, which was higher than 13.3 % of observation group (p<0.05); After treatment, the retinal neovascularization fluorescein leakage area decreased to 241.3±12.44 mm 2 and 249.3±16.12 mm 2 , respectively; The occurrence rate of complications in observation group was 30 %, while in control group was 56.7 %; The incidence of adverse drug reactions in both groups was basically similar (p>0.05). Minocycline has a definite effect on patients with diabetic retinopathy. It can improve the vision of diabetic retinopathy patients; effectively reduce the stages of diabetic retinopathy, the leakage area of fluorescein in retinal neovascularization and the occurrence of related complications. It has no obvious adverse reactions and is worthy of clinical promotion.

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

Cited by 9 publications

References 35 publications

Ocular findings, surgery details and outcomes in proliferative diabetic retinopathy patients with chronic kidney disease

Ocular findings, surgery details and outcomes in proliferative diabetic retinopathy patients with chronic kidney disease

Potential bias of preoperative intravitreal anti-VEGF injection for complications of proliferative diabetic retinopathy

Analysis of the Clinical Efficacy of Minocycline in the Treatment of Diabetic Retinopathy

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