Visual and anatomical outcomes following vitrectomy for complications of diabetic retinopathy: The DRIVE UK Study

Gupta, Bhaskar; Sivaprasad, Sobha; Wong, Roger; Laidlaw, Alistair; Jackson, Timothy L.; McHugh, Dominic; Williamson, Tom H.

doi:10.1038/eye.2011.321

Cited by 81 publications

(97 citation statements)

References 18 publications

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“…A follow-up study reported similar results after 4 years [80]. In another study, 87% of eyes with non-clearing diabetic vitreous hemorrhage improved by at least 3 lines of visual acuity at 1 year [81].…”

Section: Pars Plana Vitrectomysupporting

confidence: 63%

“…While anatomic success rates of more than 90% have been reported [83,84], visual outcomes have been mixed. In a representative study, only 50% of eyes with diabetic traction retinal detachment had visual acuity improvement of 3 lines or more after pars plana vitrectomy [81]. Other studies have reported similar results with less than 40% of eyes achieving final visual acuity of at least 20/100 [85,86].…”

Section: Pars Plana Vitrectomysupporting

confidence: 61%

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New Therapeutic Approaches in Diabetic Retinopathy

et al. 2015

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■ AbstractDiabetic retinopathy is a common microvascular complication of diabetes mellitus. It affects a substantial proportion of US adults over age 40. The condition is a leading cause of visual loss. Much attention has been given to expanding the role of current treatments along with investigating various novel therapies and drug delivery methods. In the treatment of diabetic macular edema (DME), intravitreal pharmacotherapies, especially anti-vascular endothelial growth factor (anti-VEGF) agents, have gained popularity. Currently, anti-VEGF agents are often used as first-line agents in centerinvolved DME, with recent data suggesting that among these agents, aflibercept leads to better visual outcomes in patients with worse baseline visual acuities. While photocoagulation remains the standard treatment for proliferative diabetic retinopathy (PDR), recent FDA approvals of ranibizumab and aflibercept in the management of diabetic retinopathy associated with DME may suggest a potential for pharmacologic treatments of PDR as well. Novel therapies, including small interfering RNAs, chemokines, kallikreinkinin inhibitors, and various anti-angiogenic agents, are currently being evaluated for the management of diabetic retinopathy and DME. In addition to these strategies, novel drug delivery methods such as sustained-release implants and refillable reservoir implants are either under active evaluation or have recently gained FDA approval. This review provides an update on the novel developments in the treatment of diabetic retinopathy.

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Section: Pars Plana Vitrectomysupporting

confidence: 63%

Section: Pars Plana Vitrectomysupporting

confidence: 61%

New Therapeutic Approaches in Diabetic Retinopathy

et al. 2015

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“…4 To add to the complexity of the situation, the indications for vitrectomy surgery are gradually evolving with non-PDR-related tractional macular edema now being routinely operated. [5][6][7] Finally, there has been a steady reduction in the surgical complication rate [6][7][8] meaning that a lowering of the threshold for surgery has probably occurred.…”

Section: Introductionmentioning

confidence: 96%

Rate of Diabetic Vitrectomy in a Defined Geographical Part of North East England

Vaideanu

Sandhu

Ling

et al. 2014

Ophthalmic Epidemiology

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“…In advanced cases where laser treatment is either not recommended or insufficient, vitrectomy is an option to address hemorrhaging, as well as to correct retinal detachment and scarring. Vitreous surgery has proved to be a useful therapy for both severe PDR and DME, 32,33 and drastic improvement of quality of life has been reported in both cases.…”

Section: Current Therapies Surgicalmentioning

confidence: 99%

Diabetic RetinopathyUpdate on Prevention Techniques, Present Therapies, and New Leads

Marozas

Fort

2014

US Endocrinology

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Diabetes is a metabolic disease resulting from the body's insufficient production or use of insulin, a peptide hormone responsible for regulating glucose levels in the blood and tissues. Especially when improperly managed, diabetes results in a number of complications over time, affecting nearly every organ system, including the ocular tissue. In addition to increased risk for glaucoma and cataracts, the most threatening ocular implication of diabetes is diabetic retinopathy, an aggressive disorder historically clinically associated with a variety of retinal microvascular abnormalities. Disease severity is typically classified into two types: nonproliferative diabetic retinopathy (NPDR), marked by microaneurysms, intraretinal hemorrhaging, and other microvascular aberrations, and proliferative diabetic retinopathy (PDR), characterized by the onset of neovascularization and vitreal hemorrhaging.1 Diabetic macular edema (DME), another manifestation of diabetic retinopathy involving macular thickening due to fluid accumulation, is accountable for a great proportion of diabetes-related vision loss. 2 While advanced stages of PDR have classically been regarded as the most threatening to sight, visual dysfunction at all stages, even those deemed mild by clinical evaluation, is now apparent. As the leading cause of blindness in US working-age adults, 3 diabetic retinopathy has many economic implications for healthcare systems and the overall population, 4 as well as a variety of personal consequences on patient quality of life. 5,6 However, if addressed early and proactively, the incidence of severe vision loss from diabetic retinopathy can be significantly reduced. This review will discuss the systemic measures necessary for diabetic retinopathy prevention, as well as interventions currently available to delay or stop retinopathy progression once diagnosed. The limitations of present treatment options will also be addressed, as well as current developments in the search for new endpoints and technologies that may allow for earlier detection.Finally, investigations of some of the new therapies and future approaches to diabetic retinopathy research will be reviewed. Systemic Control and Preventive InterventionAs the prevalence of diabetes worldwide continuously increases, incidence of vision-threatening diabetic retinopathy is projected to nearly triple in the next 40 years. 7 For patients diagnosed with diabetes, the most important method of preventing visual complications, such as retinopathy, is to control the diabetes at a systemic level. Tight regulation of glycemia via intensive insulin therapy significantly reduces the risk for retinopathy prevalence and progression. 8 In addition to its effect on glycemic and circulating insulin levels, systemic insulin therapy has been shown to have a local impact on ocular tissue as well, including restoration of retinal insulin receptor signaling cascade and rod photoreceptor function. 9,10We recently demonstrated that both components of systemic insulin treatment-normaliza...

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Visual and anatomical outcomes following vitrectomy for complications of diabetic retinopathy: The DRIVE UK Study

Cited by 81 publications

References 18 publications

New Therapeutic Approaches in Diabetic Retinopathy

New Therapeutic Approaches in Diabetic Retinopathy

Rate of Diabetic Vitrectomy in a Defined Geographical Part of North East England

Diabetic RetinopathyUpdate on Prevention Techniques, Present Therapies, and New Leads

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Visual and anatomical outcomes following vitrectomy for complications of diabetic retinopathy: The DRIVE UK Study

Cited by 81 publications

References 18 publications

New Therapeutic Approaches in Diabetic Retinopathy

New Therapeutic Approaches in Diabetic Retinopathy

Rate of Diabetic Vitrectomy in a Defined Geographical Part of North East England

Diabetic RetinopathyUpdate on Prevention Techniques, Present Therapies, and New Leads

Contact Info

Product

Resources

About

Diabetic RetinopathyUpdate on Prevention Techniques, Present Therapies, and New Leads