Intravitreal Ranibizumab Injection at the End of Vitrectomy for Diabetic Vitreous Hemorrhage (Observational Study)

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2019 May 18

PMID 31096535

Citations 4

Authors

Xu Liang

Yue Zhang

Jia-Xing Wang

Li-Fei Wang

Wan-Rong Huang

Xin Tang

Affiliations

Soon will be listed here.

Abstract

To evaluate the outcomes and complications of intravitreal injections of ranibizumab in patients during pars plana vitrectomy for treatment of diabetic vitreous hemorrhage. This retrospective, observational, comparative study included 103 patients (103 eyes) who underwent pars plana vitrectomy for treatment of diabetic vitreous hemorrhage. Sixty-six patients received an intravitreal injection of 0.05 mg (0.05 cc) of ranibizumab at the end of surgery. Main outcome measures were the occurrence of recurrent early vitreous hemorrhage, reoperation, intraocular pressure, best corrected visual acuity. Mean follow-up time was 6 months. The rate of rebleeding in the intravitreal ranibizumab (IVR) group was 6.1% (4 eyes), which is significantly lower than the control group (24.3%, 9 eyes, P < .01). The incidence of postoperative diabetic vitreous hemorrhage (PDVH) was significantly lower in the IVR group than the control group, OR=0.26, 95% CI= (0.06, 0.95). Visual acuity 6 months after operation was better in IVR group (P<.01) There was no difference in mean intraocular pressure between the 2 groups (P=.56). The present clinical study suggests that intravitreal injection of ranibizumab is effective in the prevention of postoperative diabetic vitreous hemorrhage in eyes undergoing pars plana vitrectomy for the treatment of diabetic vitreous hemorrhage.

Citing Articles

Effect of Adjunctive Intravitreal Conbercept Injection at the End of 25G Vitrectomy on Severe Proliferative Diabetic Retinopathy: 6-Month Outcomes of a Randomised Controlled Trial.

Li H, Niu Y, Rong A, Bi Y, Xu W, Cui H Ophthalmol Ther. 2023; 12(2):1173-1180.

PMID: 36752956 PMC: 10011228. DOI: 10.1007/s40123-023-00664-6.

Is Chronic Kidney Disease Affecting the Postoperative Complications of Vitrectomy for Proliferative Diabetic Retinopathy?.

Kameda Y, Saeki T, Hanai K, Suzuki Y, Uchigata Y, Babazono T J Clin Med. 2021; 10(22).

PMID: 34830589 PMC: 8621452. DOI: 10.3390/jcm10225309.

Self-Assembling Tacrolimus Nanomicelles for Retinal Drug Delivery.

Gote V, Mandal A, Alshamrani M, Pal D Pharmaceutics. 2020; 12(11).

PMID: 33182620 PMC: 7698121. DOI: 10.3390/pharmaceutics12111072.

Characteristics and outcomes of vitrectomy for proliferative diabetic retinopathy in young versus senior patients.

Liao M, Wang X, Yu J, Meng X, Liu Y, Dong X BMC Ophthalmol. 2020; 20(1):416.

PMID: 33076873 PMC: 7574415. DOI: 10.1186/s12886-020-01688-3.

References

Lo W, Kim S, M Aaberg Sr T, Bergstrom C, Srivastava S, Yan J . Visual outcomes and incidence of recurrent vitreous hemorrhage after vitrectomy in diabetic eyes pretreated with bevacizumab (avastin). Retina. 2009; 29(7):926-31. PMC: 3033782. DOI: 10.1097/IAE.0b013e3181a8eb88. View

Stitt A, Curtis T, Chen M, Medina R, Mckay G, Jenkins A . The progress in understanding and treatment of diabetic retinopathy. Prog Retin Eye Res. 2015; 51:156-86. DOI: 10.1016/j.preteyeres.2015.08.001. View

Whitehead M, Wickremasinghe S, Osborne A, van Wijngaarden P, Martin K . Diabetic retinopathy: a complex pathophysiology requiring novel therapeutic strategies. Expert Opin Biol Ther. 2018; 18(12):1257-1270. PMC: 6299358. DOI: 10.1080/14712598.2018.1545836. View

Gillies M, Kuzniarz M, Craig J, Ball M, Luo W, Simpson J . Intravitreal triamcinolone-induced elevated intraocular pressure is associated with the development of posterior subcapsular cataract. Ophthalmology. 2005; 112(1):139-43. DOI: 10.1016/j.ophtha.2004.07.017. View

Mahalingam P, Topiwalla T, Ganesan G . Vitreous rebleed following sutureless vitrectomy: Incidence and risk factors. Indian J Ophthalmol. 2018; 66(4):558-561. PMC: 5892061. DOI: 10.4103/ijo.IJO_770_17. View

Madonna R, Balistreri C, Geng Y, De Caterina R . Diabetic microangiopathy: Pathogenetic insights and novel therapeutic approaches. Vascul Pharmacol. 2017; 90:1-7. DOI: 10.1016/j.vph.2017.01.004. View

Wakabayashi Y, Usui Y, Tsubota K, Ueda S, Umazume K, Muramatsu D . PERSISTENT OVERPRODUCTION OF INTRAOCULAR VASCULAR ENDOTHELIAL GROWTH FACTOR AS A CAUSE OF LATE VITREOUS HEMORRHAGE AFTER VITRECTOMY FOR PROLIFERATIVE DIABETIC RETINOPATHY. Retina. 2017; 37(12):2317-2325. DOI: 10.1097/IAE.0000000000001490. View

Jonas J . Intravitreal triamcinolone acetonide for diabetic retinopathy. Dev Ophthalmol. 2007; 39:96-110. DOI: 10.1159/000098502. View

Rattanapakorn T, Sanguansak T, Yospaiboon Y, Sinawat S . Intravitreal bevacizumab for proliferative diabetic retinopathy with new dense vitreous hemorrhage after full panretinal photocoagulation. Eye (Lond). 2013; 27(12):1391-6. PMC: 3869503. DOI: 10.1038/eye.2013.200. View

10.

Park D, Shin J, Kim S . Intravitreal injection of bevacizumab and triamcinolone acetonide at the end of vitrectomy for diabetic vitreous hemorrhage: a comparative study. Graefes Arch Clin Exp Ophthalmol. 2009; 248(5):641-50. DOI: 10.1007/s00417-009-1247-7. View

11.

Yeh P, Yang C, Yang C, Huang J . Cryotherapy of the anterior retina and sclerotomy sites in diabetic vitrectomy to prevent recurrent vitreous hemorrhage: an ultrasound biomicroscopy study. Ophthalmology. 2005; 112(12):2095-102. DOI: 10.1016/j.ophtha.2005.07.010. View

12.

Rodrigues G, Abe R, Zangalli C, Sodre S, Donini F, Costa D . Neovascular glaucoma: a review. Int J Retina Vitreous. 2016; 2:26. PMC: 5116372. DOI: 10.1186/s40942-016-0051-x. View

13.

Budzinskaya M, Plyukhova A, Sorokin P . [Anti-VEGF therapy resistance in neovascular age-related macular degeneration]. Vestn Oftalmol. 2017; 133(4):103-108. DOI: 10.17116/oftalma20171334103-108. View

14.

Cheema R, Mushtaq J, Al-Khars W, Al-Askar E, Cheema M . Role of intravitreal bevacizumab (Avastin) injected at the end of diabetic vitrectomy in preventing postoperative recurrent vitreous hemorrhage. Retina. 2010; 30(10):1646-50. DOI: 10.1097/IAE.0b013e3181d6def0. View

15.

Fine S, Patz A . Ten years after the Diabetic Retinopathy Study. Ophthalmology. 1987; 94(7):739-40. DOI: 10.1016/s0161-6420(87)33523-7. View

16.

. Randomized clinical trial evaluating intravitreal ranibizumab or saline for vitreous hemorrhage from proliferative diabetic retinopathy. JAMA Ophthalmol. 2013; 131(3):283-93. PMC: 4217122. DOI: 10.1001/jamaophthalmol.2013.2015. View

17.

Novak M, Rice T, Michels R, Auer C . Vitreous hemorrhage after vitrectomy for diabetic retinopathy. Ophthalmology. 1984; 91(12):1485-9. DOI: 10.1016/s0161-6420(84)34099-4. View

18.

Thompson J, De Bustros S, Michels R, Rice T, Glaser B . Results of vitrectomy for proliferative diabetic retinopathy. Ophthalmology. 1986; 93(12):1571-4. DOI: 10.1016/s0161-6420(86)33541-3. View

19.

Zimmet P, Alberti K, Shaw J . Global and societal implications of the diabetes epidemic. Nature. 2001; 414(6865):782-7. DOI: 10.1038/414782a. View

20.

Thompson J, De Bustros S, Michels R, Rice T . Results and prognostic factors in vitrectomy for diabetic vitreous hemorrhage. Arch Ophthalmol. 1987; 105(2):191-5. DOI: 10.1001/archopht.1987.01060020045025. View