Microincision Vitrectomy Surgery and Intravitreal Bevacizumab as a Surgical Adjunct to Treat Diabetic Traction Retinal Detachment

Oshima, Yusuke; Shima, Chiharu; Wakabayashi, Taku; Kusaka, Shunji; Shiraga, Fumio; Ohji, Masahito; Tano, Yasuo

doi:10.1016/j.ophtha.2008.11.005

Cited by 164 publications

(141 citation statements)

References 51 publications

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“…[2][3][4]8,9,62 There are several reports of development or progression of tractional retinal detachment (TRD) after intravitreal injection of bevacizumab before vitrectomy for advanced proliferative diabetic retinopathy (PDR). [63][64][65] In a retrospective series, 5.2% of eyes developed or had progression of TRD following injection. Time from injection to TRD was a mean of 13 days (range 3-31 days), and 9 out of 11 (81.8%) TRDs developed or progressed at 5 days or more after the injection.…”

Section: Adverse Events Following Intravitreal Anti-vegf Injections: mentioning

confidence: 99%

Adverse events and complications associated with intravitreal injection of anti-VEGF agents: a review of literature

Falavarjani

Nguyen

2013

Eye

759

505

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Intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents is increasingly used for the treatment of a wide variety of retinal diseases, including age-related macular degeneration, diabetic retinopathy and retinal vascular occlusions, and retinopathy of prematurity. Despite encouraging results in halting the disease and improving the vision, intravitreal injection of anti-VEGF agents may be associated with systemic adverse events and devastating ocular complications. In this review, we provide an overview of safety data for intravitreal injection of common anti-VEGF agents.

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Section: Adverse Events Following Intravitreal Anti-vegf Injections: mentioning

confidence: 99%

Adverse events and complications associated with intravitreal injection of anti-VEGF agents: a review of literature

Falavarjani

Nguyen

2013

Eye

759

505

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“…Intravitreal bevacizumab administered 1-2 weeks pre-operatively has been reported to facilitate surgical dissection of fibrovascular membranes in eyes with severe active PDR. 35,36,[65][66][67] The risk of recurrent vitreous cavity haemorrhage may also be reduced by this treatment. 34 However, there is a potential adverse effect because fibrovascular membrane contraction can lead to rapid development or progression of tractional retinal detachment.…”

Section: Adjunctive Pharmacotherapymentioning

confidence: 99%

“…34 However, there is a potential adverse effect because fibrovascular membrane contraction can lead to rapid development or progression of tractional retinal detachment. [66][67][68] The timing of vitrectomy surgery may therefore be critical to avoid this complication. Intravitreal bevacizumab may also be beneficial in the treatment of anterior segment neovascularisation associated with severe PDR.…”

Section: Adjunctive Pharmacotherapymentioning

confidence: 99%

Surgical management of the late complications of proliferative diabetic retinopathy

Newman

2010

Eye

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The late complications of proliferative diabetic retinopathy (PDR) comprise vitreous haemorrhage, tractional retinal detachment, combined tractional-rhegmatogenous retinal detachment, and severe fibrovascular proliferation (including macular distortion or dragging, tractional macular oedema, and media opacity due to fibrovascular tissue). This article will review the indications, techniques, and outcomes of vitrectomy surgery to treat these conditions. A careful assessment of the surgical anatomy, with particular attention to the configuration of vitreoretinal attachments, is important when determining the precise surgical procedure required. The surgical outcome after diabetic vitrectomy has steadily improved with advances in vitreoretinal surgical instrumentation and technique. Significant post-operative complications may, however, occur including cataract formation, recurrent vitreous cavity haemorrhage (early or delayed), rhegmatogenous retinal detachment, and neovascular glaucoma. Most patients will regain or retain useful vision after diabetic vitrectomy, although the visual outcome does remain unpredictable. The development of adjunctive pharmacotherapy should enable further improvements in visual outcome in the future.

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“…35 Such damage can lead to rapid formation of tractional retinal detachment. 35,36 Guidance for ranibizumab therapy Monotherapy vs combination therapy Initiating ranibizumab monotherapy is the preferred approach for visual impairment due to DME. As yet, the role of adjunctive laser is unclear.…”

mentioning

confidence: 99%

New approaches for the treatment of diabetic macular oedema: recommendations by an expert panel

Bandello¹,

Cunha-Vaz

Chong

et al. 2012

Eye

110

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The current standard therapy for patients with diabetic macular oedema (DME)Ffocal/grid laser photocoagulationFusually does not improve impaired vision, and many patients lose vision despite laser therapy. Recent approval of ranibizumab by the European Medicines Agency to treat visual impairment due to DME fulfils the previously unmet medical need for a treatment that can improve visual acuity (VA) in these patients. We reviewed 1-and 2-year clinical trial findings for ranibizumab used as treatment for DME to formulate evidence-based treatment recommendations in the context of this new therapy. DME with or without visual impairment should be considered for treatment when it fulfils the Early Treatment Diabetic Retinopathy Study (ETDRS) criteria for clinically significant oedema. For DME with centre involvement and associated vision loss due to DME, monthly ranibizumab monotherapy with treatment interruption and re-initiation based on VA stability is recommended. Laser therapy based on ETDRS guidelines is recommended for other forms of clinically significant DME without centre involvement or when no vision loss has occurred, despite centre involvement. Because these recommendations are based on randomised controlled trials of 1-2 years duration, guidance may need updating as long-term ranibizumab data become available and as additional therapeutic agents are assessed in clinical trials.

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Microincision Vitrectomy Surgery and Intravitreal Bevacizumab as a Surgical Adjunct to Treat Diabetic Traction Retinal Detachment

Cited by 164 publications

References 51 publications

Adverse events and complications associated with intravitreal injection of anti-VEGF agents: a review of literature

Adverse events and complications associated with intravitreal injection of anti-VEGF agents: a review of literature

Surgical management of the late complications of proliferative diabetic retinopathy

New approaches for the treatment of diabetic macular oedema: recommendations by an expert panel

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