Rétinopathie diabétique vasoproliférante : complications vitréorétiniennes et photocoagulation rétinienne incomplète

Zaninetti, Marc; Petropoulos, Ioannis K.; Pournaras, Constantin J.

doi:10.1016/s0181-5512(05)81068-x

Cited by 15 publications

(8 citation statements)

References 8 publications

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“…In our study, we showed a statistically significant regression of retinal ischemia and of new vessels after fill in laser therapy performed in the OR under anesthesia suggesting the role of further PRP in refractory high risk PDR before indicating invasive intraocular therapies. This correlates well with previously published data [13,23]. The majority of our patients (70.6%) were treated with pattern laser scan using low duration and power compared to the recom- mendations suggested in the literature [8].…”

supporting

confidence: 92%

“…Painful laser treatment can be a major issue when dense PRP is required [10,11]. In incomplete PRP, danger of developing further proliferative new vessels remains high despite the realized treatment [12,13]. Due to high accessibility to other treatments such as anti VEGF injections [14,15] and because of safety of sutureless vitrectomy for PDR [16], the importance of maximizing PRP before indicating invasive intraocular therapies might overlooked.…”

mentioning

confidence: 99%

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Painless Indirect Argon Laser in High Risk Proliferative Diabetic Retinopathy

Ambresin

Strueven

Pournaras

2015

Klin Monatsbl Augenheilkd

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supporting

confidence: 92%

mentioning

confidence: 99%

Painless Indirect Argon Laser in High Risk Proliferative Diabetic Retinopathy

Ambresin

Strueven

Pournaras

2015

Klin Monatsbl Augenheilkd

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“…The incidence rate of RVH in PDR patients has been reported to range from 11.8 to 75% [ 11 , 12 ]. Early studies have found that the most common causes of RVH after vitrectomy are fibrovascular ingrowth at the sclerotomy sites, residual or recurrent neovascular membrane formation on the retina, and insufficient retinal photocoagulation [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Multiple factors in the prediction of risk of recurrent vitreous haemorrhage after sutureless vitrectomy for non-clearing vitreous haemorrhage in patients with diabetic retinopathy

et al. 2020

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Background: We aimed to analyse multiple factors in the prediction of risk of postoperative recurrent vitreous haemorrhage (RVH) for non-clearing vitreous haemorrhage in patients with diabetic retinopathy (DR) who underwent sutureless vitrectomy with 23-(23G) or 25-gauge (25G) narrow-gauge systems. Methods: A retrospective consecutive case series design was used. DR patients who underwent sutureless vitrectomy for non-clearing vitreous haemorrhage between June 2017 and October 2019 were enrolled. All operations were performed at a tertiary hospital. Patient demographics and risk factors, including age, gender, duration of diabetes, preoperative fasting blood sugar levels (FBSL), systolic blood pressure (SBP), serum creatinine (Cr), urea, triamcinolone acetonide (TA), electrical coagulation, air-fluid exchange, pan-retinal photocoagulation status (PRP), anti-vascular endothelial growth factor drug (anti-VEGF), and other factors, were recorded. Patients were divided into two groups based on the timing of their postoperative RVH: immediate postoperative RVH (within 2 weeks after operation) and delayed postoperative RVH (beyond 2 weeks after operation). Results: Overall, 167 eyes (167patients) were enrolled. Seventy eyes were underwent 23G and 25G sutureless vitrectomy performed in 97 eyes, respectively. Postoperative RVH developed in 18 eyes (25.7%) in Group 23G and in 20 eyes (21.6%) in Group 25G (P = 0.540). Of these, 3 eyes (4.3%) had severed RVH in Group 23G compared with 5 eyes (5.2%) in Group 25G (P = 0.584). Delayed postoperative RVH occurred in 6 eyes (8.6%) in Group 23G and 8 eyes (8.2%) in Group 25G (P = 0.789). A binomial logistic regression analysis revealed that age, duration of diabetes, and Cr level were significantly associated with RVH in both Group 23G (P < 0.05) and Group 25G (P < 0.05). Conclusions: The incidence and severity of RVH were 25.7 and 4.3%, respectively, in Group 23G and 21.6 and 5.2%, respectively, in Group 25G. Thus, the 23G sutureless vitrectomy approach was as safe as the 25G sutureless vitrectomy approach for treating vitreous haemorrhage in patients with DR. A younger age, shorter duration of diabetes, and higher Cr levels were risk factors for postoperative RVH in sutureless vitrectomy.

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“…[ 4 ] The causes of VRB include fibrovascular ingrowth, residual neovascular membrane, insufficient pan-retinal photocoagulation (PRP), and postoperative hypotony. [ 5 9 ] The purpose of our study was to evaluate the incidence and identify the risk factors for VRB following 25-gauge sutureless PPV.…”

mentioning

confidence: 99%

Vitreous rebleed following sutureless vitrectomy: Incidence and risk factors

Mahalingam¹,

Topiwalla²,

Ganesan³

2018

Indian J Ophthalmol

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Purpose:This study aims to evaluate the incidence and risk factors for vitreous rebleed (VRB) following 25-gauge sutureless vitrectomy for vitreous hemorrhage (VH) in diabetic retinopathy.Methods:A retrospective review of 190 diabetic patients having undergone vitrectomy for VH at a tertiary eye care center was analyzed. Demographic data of patients along with risk factors such as blood sugar levels (BSL), blood pressure (BP), anticoagulant use, and pan-retinal photocoagulation status (PRP) were tabulated. Depending on the commencement of VRB, patients were divided into immediate rebleed-within 2 weeks and delayed rebleed-beyond 2–4 weeks.Results:Forty-one patients had VRB, out of which 18 patients had immediate VRB and 23 patients had delayed VRB. The average duration between vitrectomy and VRB was 3.28 months. Twenty-eight patients were male and 13 were females. Average age at presentation was 53.8 years. Thirty-four patients (82.9%) were found to have high BSL and 28 patients (68.3%) had high BP and they developed rebleed (P < 0.01) after an initial hemorrhage-free period (average = 5.15 months). Fifteen patients (36.6%) underwent first time PRP intraoperatively, and they had immediate rebleed (P < 0.01) without any hemorrhage-free period (average = 0.9 months). Eight patients (19.5%) were on perioperative anticoagulants; however, their statistical significance did not persist in the multivariable model. There were neither age nor gender predilection toward rebleed (P > 0.05).Conclusion:The incidence rate of VRB was found to be 21.6%. Age and gender did not contribute to rebleed. Intraoperative PRP was a risk factor for immediate rebleed. Poor glycemic and BP control was a risk factor for delayed rebleed.

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Rétinopathie diabétique vasoproliférante : complications vitréorétiniennes et photocoagulation rétinienne incomplète

Cited by 15 publications

References 8 publications

Painless Indirect Argon Laser in High Risk Proliferative Diabetic Retinopathy

Painless Indirect Argon Laser in High Risk Proliferative Diabetic Retinopathy

Multiple factors in the prediction of risk of recurrent vitreous haemorrhage after sutureless vitrectomy for non-clearing vitreous haemorrhage in patients with diabetic retinopathy

Vitreous rebleed following sutureless vitrectomy: Incidence and risk factors

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