Safety and effectiveness of pre-emptive diabetic vitrectomy in patients with severe, non-fibrotic retinal neovascularisation despite panretinal photocoagulation
Objectives To investigate the safety and effectiveness of pre-emptive vitrectomy in eyes with severe non-fibrotic proliferative diabetic retinopathy. Methods A multi-centre, retrospective, observational study. Pre-emptive vitrectomy was performed in non-fibrotic diabetic eyes with a visual acuity (V...
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| Veröffentlicht in: | Eye (London) 2023-06, Vol.37 (8), p.1553-1557 |
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| creator | Tan, Shi Zhuan Steel, David H. Stanzel, Boris V. Bedersdorfer, Martin Szurman, Peter Saidkasimova, Shohista Schielke, Katja Christina Kumaran, Neruban Laidlaw, David Alistair H. |
| description | Objectives
To investigate the safety and effectiveness of pre-emptive vitrectomy in eyes with severe non-fibrotic proliferative diabetic retinopathy.
Methods
A multi-centre, retrospective, observational study. Pre-emptive vitrectomy was performed in non-fibrotic diabetic eyes with a visual acuity (VA) of 20/50 or better, where there was extensive persistent neovascularisation despite prior panretinal photocoagulation, and where the fellow eye had established sight loss despite vitrectomy for tractional complications. The primary outcome measure was the VA at last visit.
Results
Twenty patients were included. The mean age was 39 ± 14 years. Fifteen patients were Type 1 diabetic. The median baseline VA was 20/30 and remained stable at 20/28 at last visit (median follow-up period: 24 months). Eight eyes (40.0%) developed post-operative vitreous cavity haemorrhage; 4 of which required a vitreous cavity washout procedure. There were no post-operative retinal detachments. The index eye remained the significantly better eye at all time points bar one month post-surgery. Regression of retinopathy grading was observed in all eyes.
Conclusion
In this pilot study, we found no sight loss with pre-emptive diabetic vitrectomy. Better eye status was maintained in this high-risk group. Further study with larger number of patients and longer-term follow-up is indicated. |
| doi_str_mv | 10.1038/s41433-022-02167-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2693777804</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2819547664</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-47bf8c3ba23631072b3fba01649ad5c9f9b4ffd479bd08e79c7872772b45a9ff3</originalsourceid><addsrcrecordid>eNp9kU1rFTEUhoMo9lr9Ay4k4MaFo_maycxSil9Q6EIFdyHJnLQpM8mYZK7cf9Of2oy3VXDRRQjkPO-bAw9CLyl5Rwnv32dBBecNYawe2smGP0I7KmTXtKIVj9GODC1pGGM_T9CznK8JqUNJnqIT3vadoB3boZtv2kE5YB1GDM6BLX4PAXLG0eElQQPzsj3h0WsDxVu89yVVLM4H7ANedPEQSsa_fbnCGfaQ4C0OMTTOmxS3QKqxoCccIO51tuukk881FgMeIS--QG0J99RyFUu0UV9WbmOeoydOTxle3N2n6Menj9_PvjTnF5-_nn04byxnXWmENK633GjGO06JZIY7owntxKDH1g5uMMK5UcjBjKQHOVjZSyYrJ1o9OMdP0Ztj75LirxVyUbPPFqZJ173XrFg3cCllT0RFX_-HXsc11eUr1dOhrQa6jWJHyqaYcwKnluRnnQ6KErX5U0d_qvpTf_wpXkOv7qpXM8P4N3IvrAL8COQ6CpeQ_v39QO0tLZSqqw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2819547664</pqid></control><display><type>article</type><title>Safety and effectiveness of pre-emptive diabetic vitrectomy in patients with severe, non-fibrotic retinal neovascularisation despite panretinal photocoagulation</title><source>MEDLINE</source><source>PubMed Central</source><source>SpringerLink Journals - AutoHoldings</source><creator>Tan, Shi Zhuan ; Steel, David H. ; Stanzel, Boris V. ; Bedersdorfer, Martin ; Szurman, Peter ; Saidkasimova, Shohista ; Schielke, Katja Christina ; Kumaran, Neruban ; Laidlaw, David Alistair H.</creator><creatorcontrib>Tan, Shi Zhuan ; Steel, David H. ; Stanzel, Boris V. ; Bedersdorfer, Martin ; Szurman, Peter ; Saidkasimova, Shohista ; Schielke, Katja Christina ; Kumaran, Neruban ; Laidlaw, David Alistair H.</creatorcontrib><description>Objectives
To investigate the safety and effectiveness of pre-emptive vitrectomy in eyes with severe non-fibrotic proliferative diabetic retinopathy.
Methods
A multi-centre, retrospective, observational study. Pre-emptive vitrectomy was performed in non-fibrotic diabetic eyes with a visual acuity (VA) of 20/50 or better, where there was extensive persistent neovascularisation despite prior panretinal photocoagulation, and where the fellow eye had established sight loss despite vitrectomy for tractional complications. The primary outcome measure was the VA at last visit.
Results
Twenty patients were included. The mean age was 39 ± 14 years. Fifteen patients were Type 1 diabetic. The median baseline VA was 20/30 and remained stable at 20/28 at last visit (median follow-up period: 24 months). Eight eyes (40.0%) developed post-operative vitreous cavity haemorrhage; 4 of which required a vitreous cavity washout procedure. There were no post-operative retinal detachments. The index eye remained the significantly better eye at all time points bar one month post-surgery. Regression of retinopathy grading was observed in all eyes.
Conclusion
In this pilot study, we found no sight loss with pre-emptive diabetic vitrectomy. Better eye status was maintained in this high-risk group. Further study with larger number of patients and longer-term follow-up is indicated.</description><identifier>ISSN: 0950-222X</identifier><identifier>EISSN: 1476-5454</identifier><identifier>DOI: 10.1038/s41433-022-02167-3</identifier><identifier>PMID: 35864162</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>692/308/409 ; 692/699/3161/3175 ; Acuity ; Adult ; Diabetes ; Diabetes Mellitus ; Diabetic Retinopathy - complications ; Diabetic Retinopathy - surgery ; Eye ; Hemorrhage ; Humans ; Laboratory Medicine ; Laser Coagulation - methods ; Medicine ; Medicine & Public Health ; Middle Aged ; Ophthalmology ; Pharmaceutical Sciences/Technology ; Pilot Projects ; Retina ; Retinal Neovascularization - surgery ; Retinopathy ; Retrospective Studies ; Risk groups ; Surgery ; Surgical Oncology ; Vitrectomy</subject><ispartof>Eye (London), 2023-06, Vol.37 (8), p.1553-1557</ispartof><rights>The Author(s), under exclusive licence to The Royal College of Ophthalmologists 2022</rights><rights>2022. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.</rights><rights>The Author(s), under exclusive licence to The Royal College of Ophthalmologists 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-47bf8c3ba23631072b3fba01649ad5c9f9b4ffd479bd08e79c7872772b45a9ff3</cites><orcidid>0000-0001-7747-7219</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41433-022-02167-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41433-022-02167-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35864162$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tan, Shi Zhuan</creatorcontrib><creatorcontrib>Steel, David H.</creatorcontrib><creatorcontrib>Stanzel, Boris V.</creatorcontrib><creatorcontrib>Bedersdorfer, Martin</creatorcontrib><creatorcontrib>Szurman, Peter</creatorcontrib><creatorcontrib>Saidkasimova, Shohista</creatorcontrib><creatorcontrib>Schielke, Katja Christina</creatorcontrib><creatorcontrib>Kumaran, Neruban</creatorcontrib><creatorcontrib>Laidlaw, David Alistair H.</creatorcontrib><title>Safety and effectiveness of pre-emptive diabetic vitrectomy in patients with severe, non-fibrotic retinal neovascularisation despite panretinal photocoagulation</title><title>Eye (London)</title><addtitle>Eye</addtitle><addtitle>Eye (Lond)</addtitle><description>Objectives
To investigate the safety and effectiveness of pre-emptive vitrectomy in eyes with severe non-fibrotic proliferative diabetic retinopathy.
Methods
A multi-centre, retrospective, observational study. Pre-emptive vitrectomy was performed in non-fibrotic diabetic eyes with a visual acuity (VA) of 20/50 or better, where there was extensive persistent neovascularisation despite prior panretinal photocoagulation, and where the fellow eye had established sight loss despite vitrectomy for tractional complications. The primary outcome measure was the VA at last visit.
Results
Twenty patients were included. The mean age was 39 ± 14 years. Fifteen patients were Type 1 diabetic. The median baseline VA was 20/30 and remained stable at 20/28 at last visit (median follow-up period: 24 months). Eight eyes (40.0%) developed post-operative vitreous cavity haemorrhage; 4 of which required a vitreous cavity washout procedure. There were no post-operative retinal detachments. The index eye remained the significantly better eye at all time points bar one month post-surgery. Regression of retinopathy grading was observed in all eyes.
Conclusion
In this pilot study, we found no sight loss with pre-emptive diabetic vitrectomy. Better eye status was maintained in this high-risk group. Further study with larger number of patients and longer-term follow-up is indicated.</description><subject>692/308/409</subject><subject>692/699/3161/3175</subject><subject>Acuity</subject><subject>Adult</subject><subject>Diabetes</subject><subject>Diabetes Mellitus</subject><subject>Diabetic Retinopathy - complications</subject><subject>Diabetic Retinopathy - surgery</subject><subject>Eye</subject><subject>Hemorrhage</subject><subject>Humans</subject><subject>Laboratory Medicine</subject><subject>Laser Coagulation - methods</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Ophthalmology</subject><subject>Pharmaceutical Sciences/Technology</subject><subject>Pilot Projects</subject><subject>Retina</subject><subject>Retinal Neovascularization - surgery</subject><subject>Retinopathy</subject><subject>Retrospective Studies</subject><subject>Risk groups</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Vitrectomy</subject><issn>0950-222X</issn><issn>1476-5454</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kU1rFTEUhoMo9lr9Ay4k4MaFo_maycxSil9Q6EIFdyHJnLQpM8mYZK7cf9Of2oy3VXDRRQjkPO-bAw9CLyl5Rwnv32dBBecNYawe2smGP0I7KmTXtKIVj9GODC1pGGM_T9CznK8JqUNJnqIT3vadoB3boZtv2kE5YB1GDM6BLX4PAXLG0eElQQPzsj3h0WsDxVu89yVVLM4H7ANedPEQSsa_fbnCGfaQ4C0OMTTOmxS3QKqxoCccIO51tuukk881FgMeIS--QG0J99RyFUu0UV9WbmOeoydOTxle3N2n6Menj9_PvjTnF5-_nn04byxnXWmENK633GjGO06JZIY7owntxKDH1g5uMMK5UcjBjKQHOVjZSyYrJ1o9OMdP0Ztj75LirxVyUbPPFqZJ173XrFg3cCllT0RFX_-HXsc11eUr1dOhrQa6jWJHyqaYcwKnluRnnQ6KErX5U0d_qvpTf_wpXkOv7qpXM8P4N3IvrAL8COQ6CpeQ_v39QO0tLZSqqw</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Tan, Shi Zhuan</creator><creator>Steel, David H.</creator><creator>Stanzel, Boris V.</creator><creator>Bedersdorfer, Martin</creator><creator>Szurman, Peter</creator><creator>Saidkasimova, Shohista</creator><creator>Schielke, Katja Christina</creator><creator>Kumaran, Neruban</creator><creator>Laidlaw, David Alistair H.</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7747-7219</orcidid></search><sort><creationdate>20230601</creationdate><title>Safety and effectiveness of pre-emptive diabetic vitrectomy in patients with severe, non-fibrotic retinal neovascularisation despite panretinal photocoagulation</title><author>Tan, Shi Zhuan ; Steel, David H. ; Stanzel, Boris V. ; Bedersdorfer, Martin ; Szurman, Peter ; Saidkasimova, Shohista ; Schielke, Katja Christina ; Kumaran, Neruban ; Laidlaw, David Alistair H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-47bf8c3ba23631072b3fba01649ad5c9f9b4ffd479bd08e79c7872772b45a9ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>692/308/409</topic><topic>692/699/3161/3175</topic><topic>Acuity</topic><topic>Adult</topic><topic>Diabetes</topic><topic>Diabetes Mellitus</topic><topic>Diabetic Retinopathy - complications</topic><topic>Diabetic Retinopathy - surgery</topic><topic>Eye</topic><topic>Hemorrhage</topic><topic>Humans</topic><topic>Laboratory Medicine</topic><topic>Laser Coagulation - methods</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Ophthalmology</topic><topic>Pharmaceutical Sciences/Technology</topic><topic>Pilot Projects</topic><topic>Retina</topic><topic>Retinal Neovascularization - surgery</topic><topic>Retinopathy</topic><topic>Retrospective Studies</topic><topic>Risk groups</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Vitrectomy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tan, Shi Zhuan</creatorcontrib><creatorcontrib>Steel, David H.</creatorcontrib><creatorcontrib>Stanzel, Boris V.</creatorcontrib><creatorcontrib>Bedersdorfer, Martin</creatorcontrib><creatorcontrib>Szurman, Peter</creatorcontrib><creatorcontrib>Saidkasimova, Shohista</creatorcontrib><creatorcontrib>Schielke, Katja Christina</creatorcontrib><creatorcontrib>Kumaran, Neruban</creatorcontrib><creatorcontrib>Laidlaw, David Alistair H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Eye (London)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tan, Shi Zhuan</au><au>Steel, David H.</au><au>Stanzel, Boris V.</au><au>Bedersdorfer, Martin</au><au>Szurman, Peter</au><au>Saidkasimova, Shohista</au><au>Schielke, Katja Christina</au><au>Kumaran, Neruban</au><au>Laidlaw, David Alistair H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Safety and effectiveness of pre-emptive diabetic vitrectomy in patients with severe, non-fibrotic retinal neovascularisation despite panretinal photocoagulation</atitle><jtitle>Eye (London)</jtitle><stitle>Eye</stitle><addtitle>Eye (Lond)</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>37</volume><issue>8</issue><spage>1553</spage><epage>1557</epage><pages>1553-1557</pages><issn>0950-222X</issn><eissn>1476-5454</eissn><abstract>Objectives
To investigate the safety and effectiveness of pre-emptive vitrectomy in eyes with severe non-fibrotic proliferative diabetic retinopathy.
Methods
A multi-centre, retrospective, observational study. Pre-emptive vitrectomy was performed in non-fibrotic diabetic eyes with a visual acuity (VA) of 20/50 or better, where there was extensive persistent neovascularisation despite prior panretinal photocoagulation, and where the fellow eye had established sight loss despite vitrectomy for tractional complications. The primary outcome measure was the VA at last visit.
Results
Twenty patients were included. The mean age was 39 ± 14 years. Fifteen patients were Type 1 diabetic. The median baseline VA was 20/30 and remained stable at 20/28 at last visit (median follow-up period: 24 months). Eight eyes (40.0%) developed post-operative vitreous cavity haemorrhage; 4 of which required a vitreous cavity washout procedure. There were no post-operative retinal detachments. The index eye remained the significantly better eye at all time points bar one month post-surgery. Regression of retinopathy grading was observed in all eyes.
Conclusion
In this pilot study, we found no sight loss with pre-emptive diabetic vitrectomy. Better eye status was maintained in this high-risk group. Further study with larger number of patients and longer-term follow-up is indicated.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>35864162</pmid><doi>10.1038/s41433-022-02167-3</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-7747-7219</orcidid></addata></record> |
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| ispartof | Eye (London), 2023-06, Vol.37 (8), p.1553-1557 |
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| subjects | 692/308/409 692/699/3161/3175 Acuity Adult Diabetes Diabetes Mellitus Diabetic Retinopathy - complications Diabetic Retinopathy - surgery Eye Hemorrhage Humans Laboratory Medicine Laser Coagulation - methods Medicine Medicine & Public Health Middle Aged Ophthalmology Pharmaceutical Sciences/Technology Pilot Projects Retina Retinal Neovascularization - surgery Retinopathy Retrospective Studies Risk groups Surgery Surgical Oncology Vitrectomy |
| title | Safety and effectiveness of pre-emptive diabetic vitrectomy in patients with severe, non-fibrotic retinal neovascularisation despite panretinal photocoagulation |
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