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Hiroshi Goto - One of the best experts on this subject based on the ideXlab platform.
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persistent overproduction of intraocular vascular endothelial growth factor as a cause of late vitreous hemorrhage after Vitrectomy for proliferative diabetic retinopathy
Retina-the Journal of Retinal and Vitreous Diseases, 2017Co-Authors: Yoshihiro Wakabayashi, Yoshihiko Usui, Kinya Tsubota, Shunichiro Ueda, Kazuhiko Umazume, Daisuke Muramatsu, Hiroshi GotoAbstract:PURPOSE The purpose of this study was to investigate whether vitreous levels of vascular endothelial growth factor (VEGF) predict late vitreous hemorrhage (VH) after Vitrectomy for proliferative diabetic retinopathy, and how VEGF level changes in patients with postoperative late VH. METHODS Eighty-five eyes of 68 patients with proliferative diabetic retinopathy who underwent Vitrectomy were analyzed retrospectively. Vitreous samples were collected from eyes undergoing primary Vitrectomy and from eyes with late VH undergoing second Vitrectomy. Vitreous VEGF levels were measured using enzyme-linked immunosorbent assay. The relationship between VEGF level and late VH (>4 weeks) occurring during follow-up as well as clinical findings, and changes in VEGF level in eyes with late VH undergoing second Vitrectomy were analyzed. RESULTS Late VH occurred in 20 (24%) of 85 eyes, and 9 eyes required second Vitrectomy. Vitreous levels of VEGF were significantly higher (median: 1,945 pg/mL; P < 0.0001) in eyes with late VH than in those without. Preexisting iris neovascularization (P < 0.0001), hypertension (P = 0.002), and proteinuria (P = 0.040) were also significant risk factors of late VH. Multivariate logistic regression analysis showed that a higher vitreous VEGF level was independently associated with a risk of postoperative late VH in patients with proliferative diabetic retinopathy (odds ratio: 20.8, 95% confidence interval: 2.72-159.47; P = 0.003). Vitreous VEGF level at second Vitrectomy in patients with late VH was significantly lower compared with that at primary Vitrectomy, but remained elevated (median: 1,610 pg/mL; P = 0.023). CONCLUSION In patients with proliferative diabetic retinopathy, high intraocular VEGF level at primary Vitrectomy was identified as an independent risk factor of postoperative late VH. Persistent overproduction of intraocular VEGF may be associated with postoperative late VH.
Neil M Bressler - One of the best experts on this subject based on the ideXlab platform.
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ranibizumab plus prompt or deferred laser for diabetic macular edema in eyes with Vitrectomy before anti vascular endothelial growth factor therapy
Retina-the Journal of Retinal and Vitreous Diseases, 2015Co-Authors: Susan B Bressler, Brian B. Berger, Michele Melia, Adam R Glassman, Talat Almukhtar, Lee M Jampol, Michel Shami, Neil M BresslerAbstract:Background The approach to managing diabetic macular edema in eyes with previous Vitrectomy is based on limited evidence. Therefore, an exploratory post hoc assessment of 3-year data from eyes with and without Vitrectomy before randomization in a DRCR.net trial that evaluated ranibizumab + prompt or deferred laser for diabetic macular edema is presented. Methods Visual acuity and optical coherence tomography outcomes were compared between eyes with and without previous Vitrectomy. Results At baseline, eyes with previous Vitrectomy (n = 25) had longer duration of diabetes, worse visual acuity, less thickened central subfield measurements on optical coherence tomography and were more apt to have worse diabetic retinopathy severity level or previous treatment for macular edema or cataract surgery than eyes without a history of Vitrectomy (n = 335). Analyses adjusted for these baseline imbalances did not identify substantial differences between eyes with and without previous Vitrectomy at each annual visit through 3 years for the favorable visual acuity, optical coherence tomography central subfield thickness, or volume outcomes, although optical coherence tomography improvement appeared slower in Vitrectomy eyes during the first year. Conclusion This study provides little evidence that the beneficial clinical outcomes for patients with center-involved diabetic macular edema treated with anti-vascular endothelial growth factor are affected in the long term by previous Vitrectomy.
Tetsuro Oshika - One of the best experts on this subject based on the ideXlab platform.
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changes in corneal topography after 25 gauge transconjunctival sutureless Vitrectomy versus after 20 gauge standard Vitrectomy
Ophthalmology, 2007Co-Authors: Fumiki Okamoto, C Okamoto, N Sakata, K Hiratsuka, N Yamane, Takahiro Hiraoka, Yuichi Kaji, Tetsuro OshikaAbstract:Purpose To evaluate the changes in regular and irregular corneal astigmatism after 25-gauge transconjunctival sutureless Vitrectomy and 20-gauge standard Vitrectomy. Design Prospective observational comparative case series. Participants Thirty-two eyes of 32 patients undergoing 25-gauge transconjunctival sutureless Vitrectomy and 25 eyes of 24 patients undergoing 20-gauge standard Vitrectomy. Methods Corneal topography was obtained preoperatively and at 2 weeks and 1 month postoperatively. Main Outcome Measures The dioptric data of the central 3-mm zone of the cornea were decomposed using Fourier harmonic analysis into spherical power, regular astigmatism, asymmetry, and higher-order irregularity. Results None of the 4 Fourier indices changed throughout the observation period in the 25-gauge group. In the 20-gauge group, regular astigmatism, asymmetry, and higher-order irregularity were increased significantly at 2 weeks after Vitrectomy ( P P U test). Conclusions Twenty-five–gauge transconjunctival sutureless Vitrectomy does not induce significant changes in corneal topography and exerts little influence on the optical quality of the cornea.
Kyu Hyung Park - One of the best experts on this subject based on the ideXlab platform.
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a case of sympathetic ophthalmia presenting with extraocular symptoms and conjunctival pigmentation after repeated 23 gauge Vitrectomy
Ocular Immunology and Inflammation, 2010Co-Authors: Kyu Hyung ParkAbstract:PURPOSE: To report a case of sympathetic ophthalmia presenting with extraocular symptoms after 23-gauge sutureless Vitrectomy. METHODS: Observational case report. RESULTS: A 29-year-old woman underwent 23-gauge sutureless Vitrectomy for spontaneous rhegmatogenous retinal detachment in the right eye. After Vitrectomy, dense conjunctival pigmentations developed around the sclerotomy sites. One month after the second Vitrectomy for a recurred retinal detachment, she presented with decreased visual acuity and metamorphopsia in both eyes, headache, tinnitus, and facial swelling. She was diagnosed with sympathetic ophthamia and treated with oral prednisolone and cyclosporine. Her visual acuity and symptoms improved after treatment. CONCLUSION: Sympathetic ophthalmia can occur after 23-gauge sutureless Vitrectomy and conjunctival pigmentation may be the preceding sign.
Yoshihiro Wakabayashi - One of the best experts on this subject based on the ideXlab platform.
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persistent overproduction of intraocular vascular endothelial growth factor as a cause of late vitreous hemorrhage after Vitrectomy for proliferative diabetic retinopathy
Retina-the Journal of Retinal and Vitreous Diseases, 2017Co-Authors: Yoshihiro Wakabayashi, Yoshihiko Usui, Kinya Tsubota, Shunichiro Ueda, Kazuhiko Umazume, Daisuke Muramatsu, Hiroshi GotoAbstract:PURPOSE The purpose of this study was to investigate whether vitreous levels of vascular endothelial growth factor (VEGF) predict late vitreous hemorrhage (VH) after Vitrectomy for proliferative diabetic retinopathy, and how VEGF level changes in patients with postoperative late VH. METHODS Eighty-five eyes of 68 patients with proliferative diabetic retinopathy who underwent Vitrectomy were analyzed retrospectively. Vitreous samples were collected from eyes undergoing primary Vitrectomy and from eyes with late VH undergoing second Vitrectomy. Vitreous VEGF levels were measured using enzyme-linked immunosorbent assay. The relationship between VEGF level and late VH (>4 weeks) occurring during follow-up as well as clinical findings, and changes in VEGF level in eyes with late VH undergoing second Vitrectomy were analyzed. RESULTS Late VH occurred in 20 (24%) of 85 eyes, and 9 eyes required second Vitrectomy. Vitreous levels of VEGF were significantly higher (median: 1,945 pg/mL; P < 0.0001) in eyes with late VH than in those without. Preexisting iris neovascularization (P < 0.0001), hypertension (P = 0.002), and proteinuria (P = 0.040) were also significant risk factors of late VH. Multivariate logistic regression analysis showed that a higher vitreous VEGF level was independently associated with a risk of postoperative late VH in patients with proliferative diabetic retinopathy (odds ratio: 20.8, 95% confidence interval: 2.72-159.47; P = 0.003). Vitreous VEGF level at second Vitrectomy in patients with late VH was significantly lower compared with that at primary Vitrectomy, but remained elevated (median: 1,610 pg/mL; P = 0.023). CONCLUSION In patients with proliferative diabetic retinopathy, high intraocular VEGF level at primary Vitrectomy was identified as an independent risk factor of postoperative late VH. Persistent overproduction of intraocular VEGF may be associated with postoperative late VH.