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Intravitreal conbercept injection with panretinal photocoagulation for high-risk proliferative diabetic retinopathy with vitreous hemorrhage

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International Journal of Ophthalmology(English edition) 2024年第6期17卷 1066-1072页

作者： Yao Xu Qing Ye Wei Shen Department of Ophthalmology the Fourth Affiliated Hospital of Soochow UniversitySuzhou 215000Jiangsu ProvinceChina Department of Ophthalmology Suzhou Kowloon HospitalShanghai Jiao Tong University School of MedcineSuzhou 215000Jiangsu ProvinceChina Department of Ophthalmology the First Affiliated Hospital of Soochow UniversitySuzhou 215000Jiangsu ProvinceChina

AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated by mild or moderate vitreous hemorrhage(VH),with or without diabetic macular edema(DME).METHODS:Patients diagnosed with VH with/without DME secondary to HR-PDR and received PRP combined with IVC injections were recruited in this retrospective study.Upon establishing the patient’s diagnosis,an initial IVC was performed,followed by prompt administration of PRP.In cases who significant bleeding persisted and impeded the laser operation,IVC was sustained before supplementing with PRP.Following the completion of PRP,patients were meticulously monitored for a minimum of six months.Laser therapy and IVC injections were judiciously adjusted based on fundus fluorescein angiography(FFA)results.Therapeutic effect and the incidence of adverse events were observed.RESULTS:Out of 42 patients(74 eyes),29 were male and 13 were female,with a mean age of 59.17±12.74y(33-84y).The diabetic history was between 1wk and 26y,and the interval between the onset of visual symptoms and diagnosis of HR-PDR was 1wk-1y.The affected eye received 2.59±1.87(1-10)IVC injections and underwent 5.5±1.02(4-8)sessions of PRP.Of these,68 eyes received PRP following 1 IVC injection,5 eyes after 2 IVC injections,and 1 eye after 3 IVC injections.Complete absorption of VH was observed in all 74 eyes 5-50wk after initial treatment,with resolution of DME in 51 eyes 3-48wk after initial treatment.A newly developed epiretinal membrane was noted in one eye.Visual acuity significantly improved in 25 eyes.No complications such as glaucoma,retinal detachment,or endophthalmitis were reported.CONCLUSION:The study suggests that the combination of PRP with IVC injections is an effective and safe modality for treating diabetic VH in patients with HR-PDR.

关键词： conbercept panretinal photocoagulation high-risk proliferative diabetic retinopathy vitreous hemorrhage

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Efficacy of intravitreal conbercept combined with panretinal photocoagulation for severe nonproliferative diabetic retinopathy without macular edema

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International Journal of Ophthalmology(English edition) 2022年第4期15卷 615-619页

作者： Ning Zhao Jian Guan Na Cai Ning-Ning Liu Department of Ophthalmology the First Affiliated Hospital of China Medical UniversityShenyang 110001Liaoning ProvinceChina

AIM: To assess efficacy of intravitreal conbercept(IVC) injection in combination with panretinal photocoagulation(PRP) vs PRP alone in patients with severe nonproliferative diabetic retinopathy(SNPDR) without macular edema(ME).METHODS: Forty-eight patients with SNPDR without ME(56 eyes) were divided into the PRP group and IVC+PRP group(the pulse group) in this retrospective clinical study. Conbercept was intravitreally administered to patients in the pulse group 1 wk before treatment with PRP and followed up for 1, 3, and 6 mo. The best-corrected visual acuity(BCVA, log MAR), center foveal thickness(CFT), visual acuity(VA) improvement, and adverse reactions were compared between groups.RESULTS: In the PRP group, the BCVA reduced at 1 and 3 mo before improving at 6 mo. In the pulse group, baseline BCVA decreased continuously at 1 mo, increased at 3 and 6 mo. BCVA in the pulse group was better than that in the PRP group at 1, 3, and 6 mo. There was an increase in CFT in the PRP group during follow-up compared with baseline. In the pulse group, CFT was increased at 1 mo relative to baseline, steadily decreased to the baseline level at 3 and 6 mo. There was a more significant reduction in CFT in the pulse group during follow-up compared with the PRP group. The effective rates of VA in the PRP and the pulse groups were 81.48% and 100%, respectively. CONCLUSION: As PRP pretreatment, a single dose of IVC administration has beneficial effects for preventing PRPinduced foveal thickening and increasing VA in patients with SNPDR without ME.

关键词： conbercopt panretinal photocoagulation severe nonproliferative diabetic retinopathy

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Simultaneous pars plana vitrectomy,panretinal photocoagulation,cryotherapy,and Ahmed valve implantation for neovascular glaucoma

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International Journal of Ophthalmology(English edition) 2021年第9期14卷 1396-1401页

作者： Carolina Bernal-Morales Marina Dotti-Boada Alvaro Olate-Perez Manuel J.Navarro-Angulo Laura Pelegrín Marc Figueras-Roca Institut Clínic d’Oftalmologia(ICOF) Hospital ClínicBarcelona 08028Spain August Pi i Sunyer Biomedical Research Institute(IDIBAPS) Barcelona 08028Spain

AIM:To describe and evaluate the efficacy of Ahmed glaucoma valve implantation(AGV)combined with pars plana vitrectomy(PPV)in a single surgical act for the treatment of advanced neovascular glaucoma(NVG).METHODS:Retrospective observational case series included 51 eyes from 50 patients with severe NVG treated with PPV,AGV,and panretinal photocoagulation and/or cryotherapy in a single surgical act during a 13-year period(2005-2018).Preoperative,intraoperative and postoperative data at day 1 and months 1,3,6,21,and 24 were systematically collected.Definition of surgical success was stablished at IOP between 6 and 21 mm Hg with or without topical treatment.RESULTS:Main indications for surgery were NVG secondary to proliferative diabetic retinopathy(39.2%)and central retinal vein occlusion(37.3%).Mean(±SD)preoperative IOP was 42.0±11.2 mm Hg decreasing to 15.5±7.1 mm Hg at 12 mo and 15.8±9.1 mm Hg at 24 mo of follow up.Cumulative incidence of success of IOP control was 76.0%at first postoperative month,reaching 88.3%at 6 mo.Prevalence of successful IOP control at long term was 74.4%at 12 mo and 71.4%at 24 mo.Eye evisceration for unsuccessful NVG management was required in 1 case(2.0%).CONCLUSION:Combination of AGV implantation and PPV in a single act may be a suitable option for severe forms of NVG in a case-by-case basis for effective IOP control and a complete panretinal photocoagulation.

关键词： neovascular glaucoma Ahmed valve pars plana vitrectomy panretinal photocoagulation cryotherapy

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Change in subfoveal choroidal thickness after argon laser panretinal photocoagulation

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International Journal of Ophthalmology(English edition) 2013年第4期6卷 505-509页

作者： Ga Eun Cho Hee Yun Cho Yun Taek Kim Department of Ophthalmology Ewha Womans University School of Medicine Department of Ophthalmology Hanyang University School of Medicine

AIMTo evaluate changes in subfoveal choroidal thickness (SFCT) and macular thickness as measured by enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) after argon laser panretinal photocoagu... 详细信息

关键词： choroidal thickness diabetic retinopathy EDI-OCT macular edema panretinal photocoagulation

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Flanibizumab Plus Combined Surgery for Treatment o Neovascular Glaucoma with Vitreous Hemorrhage

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Chinese Medical Journal 2015年第15期128卷 2078-2083页

作者： Xiu-Juan Li Xiao-Peng Yang Qiu-Ming Li Yu-Ying Wang Xiao-Bei Lyu Department of Ophthalmology The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan 450052 China Department of Medical Equipment The First Affiliated Hospital of Zhengzhou University Zhengzhou Henan 450052 China

Background：Neovascular glaucoma （NVG） is a refractory glaucoma.The management of NVG is very difficult,and it is more difficult when combined with vitreous hemorrhage.The aim of this study was to investigate the effects of ranibizumab plus combined surgery for NVG with vitreous hemorrhage.Methods：A total of 26 eyes of 26 NVG patients with vitreous hemorrhage were recruited in this study.The patients aged from 36 to 63 years with a mean age of 51.97 ± 7.60 years.The mean intraocular pressure （IOP） was 46.38 ± 5.75 mmHg （1 mmHg =0.133 kPa） while being treated with the maximum medical therapy.The mean best-corrected visual acuities converted to logarithm of the minimum angle of resolution （logMAR BCVA） was 2.62 ± 0.43.All the patients underwent intravitreal injection of 0.5 mg （0.05 ml） ranibizumab combined with pars plana vitrectomy （PPV）,pars plana lensectomy （PPL） with a preserved anterior capsule,panretinal photocoagulation （PRP）,and trabeculectomy （intravitreal ranibizumab [IVR] ＋ PPV ＋ PPL ＋ PRP ＋ trabeculectomy）.The IOP and logMAR BCVA were the main outcome measures in this study.Results：The follow-up period was 12 months.The mean postoperative IOPs were 26.38 ± 3.75 mmHg,21.36 ± 3.32 mmHg,1 8.57 ± 3.21 mmHg,and 16.68 ± 2.96 mmHg,respectively at 7 days,1 month,3 months,and 12 months after PPV ＋ PPL ＋ PRP ＋ trabeculectomy.At the last follow-up,the mean IOP was significantly lower than the preoperative one （t =6.612,P =0.001）.At 7 days,1 month,3 months,and 12 months after PPV ＋ PPL ＋ PRP ＋ trabeculectomy,the mean logMAR BCVA were 1.30 ± 0.36,1.29 ± 0.37,1.29 ± 0.39,and 1.26 ± 0.29,respectively.At the last follow-up,the mean logMAR BCVA was significantly improved,and the difference was statistically significant compared with preoperative one （t =6.133,P =0.002）.The logMAR BCVA improved in 22 eyes （84.62%）,and remained stable in 4 eyes （15.38%）.The neovascularization in the iris and the angle regressed significantly in all patients 7 days after ranibizumab injection.No serious complications occurred during 12 mon

关键词： Neovascular Glaucoma panretinal photocoagulation Pars Plana Vitrectomy Ranibizumab Trabeculectomy

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Review of the management of sight-threatening diabetic retinopathy during pregnancy

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World Journal of Diabetes 2021年第9期12卷 1386-1400页

作者： Priscilla Peixi Choo Norshamsiah Md Din Nooraniah Azmi Mae-Lynn Catherine Bastion Department of Ophthalmology Universiti Kebangsaan Malaysia Medical CentreKuala Lumpur 56000Wilayah PersekutuanMalaysia Department of Ophthalmology Universiti Putra MalaysiaSerdang 43400SelangorMalaysia

Diabetes mellitus(DM)is a noncommunicable disease reaching epidemic proportions around the world.It affects younger individuals,including women of childbearing age.Diabetes can cause diabetic retinopathy(DR),which is potentially sight threatening when severe nonproliferative DR(NPDR),proliferative DR(PDR),or sight-threatening diabetic macular oedema(STDME)develops.Pregnancy is an independent risk factor for the progression of DR.Baseline DR at the onset of pregnancy is an important indicator of progression,with up to 10% of women with baseline NPDR progressing to PDR.Progression to sight-threatening DR(STDR)during pregnancy causes distress to the patient and often necessitates ocular treatment,which may have a systemic effect.Management includes prepregnancy counselling and,when possible,conventional treatment prior to pregnancy.During pregnancy,closer follow-up is required for those with a long duration of DM,poor baseline control of blood sugar and blood pressure,and worse DR,as these are risk factors for progression to STDR.Conventional treatment with anti-vascular endothelial growth factor agents for STDME can potentially lead to foetal loss.Treatment with laser photocoagulation may be preferred,and surgery under general anaesthesia should be avoided.This review provides a management plan for STDR from the perspective of practising ophthalmologists.A review of strategies for maintaining the eyesight of diabetic women with STDR with emphasis on prepregnancy counselling and planning,monitoring and safe treatment during pregnancy,and management of complications is presented.

关键词： Sight-threatening diabetic retinopathy Severe nonproliferative diabetic retinopathy Proliferative diabetic retinopathy Diabetic macula oedema Pregnancy panretinal photocoagulation

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