Enzymatic vitrectomy for diabetic retinopathy and diabetic macular edema

作     者：Manuel Diaz-Llopis Patricia Udaondo Jose Maria Millán J Fernando Arevalo 

作者机构：Department of OphthalmologyUniversity and Polytechnic Hospital La Fe of Valencia46009 ValenciaSpain Department of GeneticsHospital Universitario La Fe of Valencia46009 ValenciaSpain Retina DivisionWilmer Eye InstituteJohns Hopkins University School of MedicineBaltimoreMD 21231United States King Khaled Eye Specialist HospitalRiyadh 11462Saudi Arabia 

出 版 物：《World Journal of Diabetes》 (世界糖尿病杂志（英文版）（电子版）)

年 卷 期：2013年第4卷第6期

页      面：319-323页

学科分类：1002[医学-临床医学] 100212[医学-眼科学] 10[医学] 

主　　题：Enzymatic vitrectomy Autologous plasmin Diabetic macular edema Diabetic retinopathy 

摘      要：The aim of this paper is to determine the role of enzymatic vitrectomy performed by intravitreal injection of autologous plasmin enzyme(APE)in the management of diabetic retinopathy and diabetic macular edema(DME).Diabetic patients with proliferative diabetic retinopathy or DME and evident posterior hyaloid adherence to the retinal surface were included.All cases were treated with an initial intravitreal injection of APE and reevaluated one month later,measuring changes in best-corrected visual acuity(BCVA),macular thickness and the status of the posterior hyaloid.A second APE injection was performed in cases with no evident posterior vitreous detachment(PVD)after the initial treatment.Sixty-three eyes were included in the present review.A complete PVD appeared in 38%of cases(24 eyes)after one injection of plasmin and the total increased to 51%(32 eyes)after the second injection,separated at least by one month.The central macular thickness improved in all cases(100%)and BCVA in89%.Finally,in 50%of eyes with proliferative diabetic retinopathy,a high reduction of new vessels regression was observed.Enzymatic vitrectomy could be considered a good therapeutic alternative in diabetic retinopathy and macular edema.