Vol 3, No 2 (2018)
Case report
Published online: 2018-11-29
Complex treatment of progressive proliferative diabetic retinopathy with concomitant diabetic macular edema — a case report
DOI: 10.5603/OJ.2018.0035
Ophthalmol J 2018;3(2):68-72.
Abstract
Proliferative diabetic retinopathy (PDR) is a major cause of visual impairment in working — age adult population
worldwide. The purpose of this article is to report the long observation and treatment of a patient with severe PDR.
We present a case of 42 years old female who had been diagnosed with diabetes mellitus type 1 thirteen years ago,
presenting a progressive PDR and macular edema in both eyes. The patient was monitored during three years of
the follow-up. The treatment included laser photocoagulation, anty-VEGF injections and the surgical treatment
including vitrectomy with ILM peeling and gas or silicone oil tamponade.
Keywords: proliferative diabetic retinopathydiabetic macular edemaanty-VEGF drugsvitrectomy
References
- Kharroubi AT, Darwish HM. Diabetes mellitus: The epidemic of the century. World J Diabetes. 2015; 6(6): 850–867.
- Lee R, Wong TY, Sabanayagam C. Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye Vis (Lond). 2015; 2: 17.
- Photocoagulation treatment of proliferative diabetic retinopathy. Clinical application of Diabetic Retinopathy Study (DRS) findings, DRS Report Number 8. The Diabetic Retinopathy Study Research Group. Ophthalmology. 1981; 88(7): 583–600.
- Kinshuck D. Proliferative retinopathy. http://www.diabeticretinopathy.org.uk/proliferative.html#l. (accessed January 14, 2018).
- Dugel PU, Hillenkamp J, Sivaprasad S, et al. Baseline visual acuity strongly predicts visual acuity gain in patients with diabetic macular edema following anti-vascular endothelial growth factor treatment across trials. Clin Ophthalmol. 2016; 10: 1103–1110.
- Diabetic Retinopathy with Diabetic Macular Edema. https://www.genentech-forum.com/content/dam/gene/managedcare/forum/pdfs/Disease-Information/diabetic-retinopathy-with-diabetic-macular-edema-disease-state-overview.pdf. (accessed January 14, 2018).
- Machemer R, Buettner H, Norton EW, et al. Vitrectomy: a pars plana approach. Trans Am Acad Ophthalmol Otolaryngol. 1971; 75(4): 813–820.
- Aiello LP, Avery RL, Arrigg PG, et al. Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders. N Engl J Med. 1994; 331(22): 1480–1487.
- Flynn HW, Chew EY, Simons BD, et al. Pars plana vitrectomy in the Early Treatment Diabetic Retinopathy Study. ETDRS report number 17. The Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1992; 99(9): 1351–1357.
- Kuiper EJ, Van Nieuwenhoven FA, de Smet MD, et al. The angio-fibrotic switch of VEGF and CTGF in proliferative diabetic retinopathy. PLoS One. 2008; 3(7): e2675.
- Kaiser P, Riemann C, Sears J, et al. Macular traction detachment and diabetic macular edema associated with posterior hyaloidal traction. Am J Ophthalmol. 2001; 131(1): 44–49.
- Recchia FM, Ruby AJ, Carvalho Recchia CA. Pars plana vitrectomy with removal of the internal limiting membrane in the treatment of persistent diabetic macular edema. Am J Ophthalmol. 2005; 139(3): 447–454.
- Stolba U, Binder S, Gruber D, et al. Vitrectomy for persistent diffuse diabetic macular edema. Am J Ophthalmol. 2005; 140(2): 295–301.
- Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy. Four-year results of a randomized trial: Diabetic Retinopathy Vitrectomy Study Report 5. Arch Ophthalmol. 1990; 108(7): 958–964.
- Yang CM, Yeh PT, Yang CH, et al. Bevacizumab pretreatment and long-acting gas infusion on vitreous clear-up after diabetic vitrectomy. Am J Ophthalmol. 2008; 146(2): 211–217.
- Rizzo S, Genovesi-Ebert F, Di Bartolo E, et al. Injection of intravitreal bevacizumab (Avastin) as a preoperative adjunct before vitrectomy surgery in the treatment of severe proliferative diabetic retinopathy (PDR). Graefes Arch Clin Exp Ophthalmol. 2008; 246(6): 837–842.