Macular morphologic findings on optical coherence tomography after microincision vitrectomy for proliferative diabetic retinopathy

Murakami, Tomoaki; Uji, Akihito; Ogino, Ken; Unoki, Noriyuki; Yoshitake, Shin; Dodo, Yoko; Horii, Takahiro; Nishijima, Kazuaki; Yoshimura, Nagahisa

doi:10.1007/s10384-015-0382-4

Cited by 16 publications

(13 citation statements)

References 52 publications

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“…The association between higher baseline number of HF and poorer baseline VA is in line with previous studies,[ 11 , 19 ] and could be a relevant observation for clinical practice. Often, vision loss is not the first manifestation of DME.…”

Section: Discussionsupporting

confidence: 89%

“…Various different hypotheses have emerged about the origin of HF that might in fact coexist. HF could be precursors of hard exudates,[ 6 , 8 , 9 ] migrating RPE cells,[ 10 ] degenerated photoreceptor cells,[ 11 , 19 ] or aggregations of activated immune cells, such as microglia. [ 12 ] Microglia are highly ramified phagocytic cells in the retina and are required for neuronal homeostasis and immune defense.…”

Section: Discussionmentioning

confidence: 99%

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Hyperreflective foci on optical coherence tomography associate with treatment outcome for anti-VEGF in patients with diabetic macular edema

et al. 2018

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PurposeTo investigate the relationship between baseline number of hyperreflective foci (HF) on spectral domain optical coherence tomography (SD-OCT) in patients with diabetic macular edema (DME), as well as the dynamics of HF during treatment with anti-vascular endothelial growth factor (VEGF), and treatment response.MethodsWe evaluated patients diagnosed with DME scheduled for treatment with intravitreal bevacizumab. Eyes were classified as adequate or insufficient treatment responders based on logMAR visual acuity improvement and central retinal thickness (CRT) decrease after three consecutive injections. Associations between number of HF at baseline and treatment response, the change in HF over the course of treatment, and the distribution of HF within the retinal layers were evaluated.ResultsIn 54 eyes of 41 patients, mean number of HF and CRT decreased after intravitreal treatment with bevacizumab (p = 0.002 and p<0.001 respectively). Decrease in CRT after 3 months was independently associated with a higher number of HF at baseline (estimated effect -2.61, 95% CI [-4.42–-0.31], p = 0.006). Eyes with adequate treatment response presented with more HF at baseline (OR 1.106, 95% CI [1.012–1.210], p = 0.030) than eyes with insufficient treatment response. Most HF were located within the inner retinal layers, and decrease of HF was mostly due to a decrease of inner retinal HF.ConclusionsIn patients with DME treated with anti-VEGF, higher baseline numbers of HF have predictive value for treatment response in terms of visual acuity improvement and CRT decrease after 3 months. In addition, HF were responsive to anti-VEGF therapy.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Hyperreflective foci on optical coherence tomography associate with treatment outcome for anti-VEGF in patients with diabetic macular edema

et al. 2018

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“…Center point thickness correlates weakly with post-operative VA but integrity of the external limiting membrane and ellipsoid zone are strongly correlated. [ 105 106 107 108 ]…”

Section: Clinical Indications and Resultsmentioning

confidence: 99%

Current management of diabetic tractional retinal detachments

Stewart

Browning

Landers

2018

Indian J Ophthalmol

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Twenty-five percent of diabetes-related vision loss stems from complications of proliferative diabetic retinopathy (PDR). Panretinal photocoagulation has been the preferred treatment of high-risk PDR for decades and more recently intravitreal injections of drugs that inhibit the actions of vascular endothelial growth factor have become popular. But despite these treatments PDR may progress uncontrollably to advanced pathologies such as traction retinal detachments (TRDs), combined traction/rhegmatogenous retinal detachments (TRD/RRDs), vitreous hemorrhages, rubeosis iridis, and traction maculopathies, which produce mild-to-severe loss of vision. TDR have long been the most common indication for PDR-related vitreoretinal surgery. Vitrectomy surgery is indicated for recent (<6 months duration) TRD involving the macula, progressive TRD that threatens the macula, and recent data suggest that chronic macula-involving TRDs (>6 months duration) may also benefit. Combined TRD/RRD represents a particularly challenging surgical condition but advances in surgical instrumentation, dissection techniques, and post-operative tamponade have produced excellent success rates. The recent development of small-gauge vitrectomy systems has persuaded most surgeons to switch platforms since these appear to produce shorter surgical times and quicker post-operative recoveries. Pre-operative injections of bevacizumab are frequently administered for persistent neovascularization to facilitate surgical dissection of pre-retinal fibrosis and reduce the incidence of post-operative hemorrhages. Recent trends toward earlier surgical intervention and expanded indications are likely to continue as surgical instrumentation and techniques are further developed.

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“…We further substantiated the relationship between HF and disease activity by the correlation we found between HF and visual acuity, in consistence with previous reports. 17 , 20 , 26 The occurrence of HF in diabetic patients may act as an early warning sign for oncoming vision loss. The exact nature of the relation of HF and visual acuity is yet unclear.…”

Section: Discussionmentioning

confidence: 99%

Retinal Hyperreflective Foci in Type 1 Diabetes Mellitus

Schreur

Breuk

Venhuizen

et al. 2020

Retina

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Macular morphologic findings on optical coherence tomography after microincision vitrectomy for proliferative diabetic retinopathy

Abstract: Foveal photoreceptor damage is associated with poor visual outcomes after microincision vitrectomy for vitreous hemorrhage due to PDR.

Cited by 16 publications

References 52 publications

Hyperreflective foci on optical coherence tomography associate with treatment outcome for anti-VEGF in patients with diabetic macular edema

Hyperreflective foci on optical coherence tomography associate with treatment outcome for anti-VEGF in patients with diabetic macular edema

Current management of diabetic tractional retinal detachments

Retinal Hyperreflective Foci in Type 1 Diabetes Mellitus

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