New Therapeutic Approaches in Diabetic Retinopathy

Vaziri, Kamyar; Schwartz, Stephen G.; Relhan, Nidhi; Kishor, Krishna; Flynn, Harry W.

doi:10.1900/rds.2015.12.196

Cited by 31 publications

(22 citation statements)

References 107 publications

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“…The DRVS also demonstrated that the benefit of surgery was maintained over a 4-year study period. Since then, the indications for diabetic vitrectomy (DV) are now known to include non-clearing vitreous hemorrhage, TRD, combined RRD/TRD, vitreomacular traction, traction-induced diabetic macular edema (DME), rubeosis iridis, and macular distortion (including dragging of the macula), to mention a few [17][18][19][20][21].…”

Section: Indications For Surgerymentioning

confidence: 99%

Diabetic Vitrectomy

Okonkwo¹

2020

The Eye and Foot in Diabetes

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Diabetic retinopathy (DR) in its advanced stage is a leading cause of blindness and visual impairment. Despite efforts at early detection of DR, disease monitoring, and medical therapy, significant proportions of people living with diabetes still progress to develop the advanced proliferative disease, which is characterized by neovascularization, actively proliferating fibrovascular membranes, and retinal traction. The surgical removal of this proliferating tissue and the treatment of the retinal ischemic drive can be very rewarding, providing significant stability of the retina and in several cases improved retinal anatomy and vision. Diabetic vitrectomy comprises a broad range of surgical techniques and maneuvers, which offer the surgeon and patient opportunity to reverse deranged vitreoretinal anatomy and improve or stabilizes vision. Advances in vitreoretinal technology have contributed greatly to more recent improved outcomes; it is expected that future advances will offer even more benefit. Keywords: diabetic retinopathy, vitreous hemorrhage, proliferative diabetic retinopathy, tractional retinal detachment, macular edema, vitrectomy Diabetic Retinopathy 2 Furthermore, in recent times, there have been significant improvements in preoperative care and evaluation, and intraoperative surgical technique, including the administration of preoperative intravitreal pharmacotherapy, development of small-gauge transconjunctival instrumentation [11][12][13], and availability of multifunctional vitrectomy probes with high cut rates [14]. These advances have made surgical outcome more predictable and have resulted in an expansion of the indication for vitrectomy in the management of the tractional complications seen in DR. This review will focus on highlighting the indications, pathophysiology and principles of surgery, preoperative considerations, intraoperative surgical techniques, and outcome of diabetic vitrectomy in contemporary times.

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Section: Indications For Surgerymentioning

confidence: 99%

Diabetic Vitrectomy

Okonkwo¹

2020

The Eye and Foot in Diabetes

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“…It has VEGF-binding domains of VEGF receptors 1 and 2. The fourth drug is pegaptanib (Macugen, from Valeant,), which binds specifically to the main pathological VEGF isomer in the eye, which is the VEGF-A165 (Osaadon et al, 2014;Vaziri et al, 2015).…”

Section: Figurementioning

confidence: 99%

Bioactive lipids and pathological retinal angiogenesis

Elmasry

Ibrahim

Abdulmoneim

et al. 2018

British J Pharmacology

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Angiogenesis, disruption of the retinal barrier, leukocyte‐adhesion and oedema are cardinal signs of proliferative retinopathies that are associated with vision loss. Therefore, identifying factors that regulate these vascular dysfunctions is critical to target pathological angiogenesis. Given the conflicting role of bioactive lipids reported in the current literature, the goal of this review is to provide the reader a clear road map of what has been accomplished so far in the field with specific focus on the role of polyunsaturated fatty acids (PUFAs)‐derived metabolites in proliferative retinopathies. This necessarily entails a description of the different retina cells, blood retina barriers and the role of (PUFAs)‐derived metabolites in diabetic retinopathy, retinopathy of prematurity and age‐related macular degeneration as the most common types of proliferative retinopathies.

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“…Mechanism of action of these agents is the inhibition of various forms of endogenous VEGF, however the duration of effect is short and intravitreal injections need to be repeated 9,10…”

Section: Introductionmentioning

confidence: 99%

Efficacy of intravitreal bevacizumab combined with pan retinal photocoagulation versus panretinal photocoagulation alone in treatment of proliferative diabetic retinopathy

Sameen¹,

Khan²,

Mukhtar³

et al. 2017

Pak J Med Sci

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Objective:To compare effectiveness of pan-retinal photocoagulation alone versus panretinal photocoagulation combined with intravitreal bevacizumab on visual acuity and central macular thickness in patients presenting with proliferative diabetic retinopathy.Methods:This Randomized controlled trial was carried out at Armed Forces Institute of ophthalmology, Pakistan from Jan 2016 to Aug 2016. Seventy six eyes of 50 patients having proliferative diabetic retinopathy and diabetic macular edema were included in the study. All the patients were subjected to detailed clinical examination that included Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), slit lamp examination of anterior and posterior segments. Optical coherence tomography (OCT) and fundus fluorescein angiography (FFA) were carried out and patients were divided in two groups (GP and GI). Three monthly sessions of Pan retinal photocoagulation (PRP) using Pattern Scan Laser (PASCAL) alone was performed in group GP while PRP along with three monthly intravitreal bevacizumab (IVB) was performed in group GI. BCVA and CMT was recorded 04 weeks after the third PRP session in both the groups.Results:Seventy six eyes of 50 patients (38 in each group) were treated with three sessions of PRP alone and PRP with IVB in Group GP and GI respectively. Mean age of the patient in group GP was 57.47± 6.08 years while that in group GI was 55.69 ±6.58. The magnitude of induced change in BCVA was 0.09 ± 0.15 in GP while 0.22 + 0.04 in GI groups while mean induced change in CMT after treatment was 77.44 ± 92.30 um and 117.50 ± 93.82 um in group GP and GI.Conclusion:Laser PRP combined with IVB has superior visual and anatomical outcome than PRP alone in patients with combined presentation of PDR and DME.

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New Therapeutic Approaches in Diabetic Retinopathy

Cited by 31 publications

References 107 publications

Diabetic Vitrectomy

Diabetic Vitrectomy

Bioactive lipids and pathological retinal angiogenesis

Efficacy of intravitreal bevacizumab combined with pan retinal photocoagulation versus panretinal photocoagulation alone in treatment of proliferative diabetic retinopathy

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