Surgical management of diabetic tractional retinal detachments

Eicosanoid Profiles in the Vitreous Humor of Patients with Proliferative Diabetic Retinopathy

“…For example, some diabetic eyes that underwent vitrectomy may have already been treated with PRP or systemic medication, which may have altered the existing levels of lipoxygenase-derived eicosanoids regardless of bevacizumab treatment. The decision of whether to treat an eye with bevacizumab prior to surgery is primarily a surgeon preference (SSRI, CJ); intravitreal administration of bevacizumab prior to surgery decreases intra-operative bleeding and makes surgical dissection of tractional membranes less difficult [ 9 ]. Thus, pre-treatment of diabetic tractional retinal detachments can help improve surgical outcomes, especially with very complex tractional detachments [ 9 , 39 ].…”

“…The decision of whether to treat an eye with bevacizumab prior to surgery is primarily a surgeon preference (SSRI, CJ); intravitreal administration of bevacizumab prior to surgery decreases intra-operative bleeding and makes surgical dissection of tractional membranes less difficult [ 9 ]. Thus, pre-treatment of diabetic tractional retinal detachments can help improve surgical outcomes, especially with very complex tractional detachments [ 9 , 39 ]. This is the primary reason why so few samples were not treated with bevacizumab prior to surgery were available for this study.…”

“…This surgery is commonly performed for non-clearing vitreous hemorrhages causing persistent vision loss. In very advanced disease, proliferative diabetic retinopathy can lead to tractional retinal detachments that often require extensive and complex surgical maneuvers for surgical success [ 8 , 9 ]. The visual prognosis for these patients can be quite poor despite successful surgical outcomes.…”

“…The current view concerning the pathogenesis of PDR involves an intraocular impetus to form de-novo aberrant retinal vessels to counteract microvascular ischemia [ 9 , 13 ]. This impetus consists of the action of the well-established vascular endothelial growth factor (VEGF), and other pro-angiogenic and pro-fibrotic growth factors (e.g., connective tissue growth factor) [ 14 , 15 , 16 ].…”

Effect of Intrasilicone Bevacizumab Injection in Diabetic Tractional Retinal Detachment Surgery: A Retrospective Case-Control Study

“…TRD is an advanced-stage form of DR that occurs when contractile elements in the vitreous and neovascular growth tissue cause detachment of the neurosensory retina [ 2 , 16 ]. Development of DR, oxidative stress, and retinal ischemia lead to the upregulation of angiogenic factors, particularly VEGF, and several chemokines [ 17 ].…”