Improving surgical efficacy of proliferative diabetic retinopathy continuously by paying attention to the basis and keeping pace with the times_Chinese Journal of Ocular Fundus Diseases

Authors：

 Xu Gezhi , Wang Keyan

Department of Ophthalmology, The Eye-ENT Hospital of Fudan University, Shanghai 200031, China;

Corresponding author：

Xu Gezhi, Email: drxugezhi@163.com

Keywords：

Diabetic retinopathy; Vitrectomy; Editorial

DOI：

10.3760/cma.j.cn511434-20210101-00001

Video：

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Proliferative diabetic retinopathy (PDR) is one of the most common cause of severe sight impairment in people with diabetes. When PDR develops to a severe stage, vitreoretinal surgery is needed to prevent its aggravation. The surgery for PDR is complicated and difficult. By deeply understanding the pathological mechanism and development law of PDR, and reasonably using various surgical techniques, assisted by emerging surgical equipment and drugs, the surgical efficacy of PDR can be continuously improved, so as to help patients improve or even restore visual function to a greater extent.

Citation： Xu Gezhi, Wang Keyan. Improving surgical efficacy of proliferative diabetic retinopathy continuously by paying attention to the basis and keeping pace with the times. Chinese Journal of Ocular Fundus Diseases, 2021, 37(1): 5-9. doi: 10.3760/cma.j.cn511434-20210101-00001 Copy

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19.	Kumar A, Hasan N, Kakkar P, et al. Comparison of clinical outcomes between "heads-up" 3D viewing system and conventional microscope in macular hole surgeries: a pilot study[J]. Indian J Ophthalmol, 2018, 66(12): 1816-1819. DOI: 10.4103/ijo.IJO_59_18.
20.	Yata K, Fujiwara T, Yamamoto A, et al. Diabetes as risk factor of cataract: differentiation by retroillumination photography and image analysis[J]. Ophthalmic Res, 1990, 22 Suppl 1: S78-80. DOI: 10.1159/000267071.
21.	Smiddy WE, Feuer W. Incidence of cataract extraction after diabetic vitrectomy[J]. Retina, 2004, 24(4): 574-581. DOI: 10.1097/00006982-200408000-00011.
22.	Holekamp NM, Shui YB, Beebe D. Lower intraocular oxygen tension in diabetic patients: possible contribution to decreased incidence of nuclear sclerotic cataract[J]. Am J Ophthalmol, 2006, 141(6): 1027-1032. DOI: 10.1016/j.ajo.2006.01.016.
23.	中华医学会眼科学分会白内障及人工晶状体学组. 中国糖尿病患者白内障围手术期管理策略专家共识(2020年)[J]. 中华眼科杂志, 2020, 56(5): 337-342. DOI: 10.3760/cma.j.cn112142-20191106-00559.Cataract and Intraocular Lens Group of the Ophthalmology Branch of the Chinese Medical Association. Expert consensus on perioperative management strategies for cataract in diabetic patients in China (2020)[J]. Chin J Ophthalmol, 2020, 56(5): 337-342. DOI: 10.3760/cma.j.cn112142-20191106-00559.
24.	Silva PS, Diala PA, Hamam RN, et al. Visual outcomes from pars plana vitrectomy versus combined pars plana vitrectomy, phacoemulsification, and intraocular lens implantation in patients with diabetes[J]. Retina, 2014, 34(10): 1960-1968. DOI: 10.1097/IAE.0000000000000171.
25.	Ljubimov AV. Diabetic complications in the cornea[J]. Vision Res, 2017, 139: 138-152. DOI: 10.1016/j.visres.2017.03.002.
26.	中华医学会糖尿病学分会视网膜病变学组. 糖尿病视网膜病变防治专家共识[J]. 中华糖尿病杂志, 2018, 10(4): 241-247. DOI: 10.3760/cma.j.issn.1674-5809.2018.04.001.Retinopathy Group of Diabetes Branch of Chinese Medical Association. Expert consensus on prevention and treatment of diabetic retinopathy[J]. Chin J Diabetes Mellitus, 2018, 10(4): 241-247. DOI: 10.3760/cma.j.issn.1674-5809.2018.04.001.

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2. Kohno R, Hata Y, Mochizuki Y, et al. Histopathology of neovascular tissue from eyes with proliferative diabetic retinopathy after intravitreal bevacizumab injection[J]. Am J Ophthalmol, 2010, 150(2): 223-229. DOI: 10.1016/j.ajo.2010.03.016.
3. Jiang T, Gu J, Zhang P, et al. The effect of adjunctive intravitreal conbercept at the end of diabetic vitrectomy for the prevention of post-vitrectomy hemorrhage in patients with severe proliferative diabetic retinopathy: a prospective, randomized pilot study[J/OL]. BMC Ophthalmol, 2020, 20(1): 43[2020-02-03]. https://pubmed.ncbi.nlm.nih.gov/32013913/. DOI: 10.1186/s12886-020-1321-9.
4. El-Sabagh HA, Abdelghaffar W, Labib AM, et al. Preoperative intravitreal bevacizumab use as an adjuvant to diabetic vitrectomy: histopathologic findings and clinical implications[J]. Ophthalmology, 2011, 118(4): 636-641. DOI: 10.1016/j.ophtha.2010.08.038.
5. Van Geest RJ, Lesnik-Oberstein SY, Tan HS, et al. A shift in the balance of vascular endothelial growth factor and connective tissue growth factor by bevacizumab causes the angiofibrotic switch in proliferative diabetic retinopathy[J]. Br J Ophthalmol, 2012, 96(4): 587-590. DOI: 10.1136/bjophthalmol-2011-301005.
6. Makita S, Hong Y, Yamanari M, et al. Optical coherence angiography[J]. Opt Express, 2006, 14(17): 7821-7840. DOI: 10.1364/oe.14.007821.
7. Hwang TS, Jia Y, Gao SS, et al. Optical coherence tomography angiography features of diabetic retinopathy[J]. Retina, 2015, 35(11): 2371-2376. DOI: 10.1097/IAE.0000000000000716.
8. Russell JF, Flynn HW Jr, Sridhar J, et al. Distribution of diabetic neovascularization on ultra-widefield fluorescein angiography and on simulated widefield OCT angiography[J]. Am J Ophthalmol, 2019, 207: 110-120. DOI: 10.1016/j.ajo.2019.05.031.
9. Pan J, Chen D, Yang X, et al. Characteristics of neovascularization in early stages of proliferative diabetic retinopathy by optical coherence tomography angiography[J]. Am J Ophthalmol, 2018, 192: 146-156. DOI: 10.1016/j.ajo.2018.05.018.
10. Hahn P, Migacz J, O'Connell R, et al. Unprocessed real-time imaging of vitreoretinal surgical maneuvers using a microscope-integrated spectral-domain optical coherence tomography system[J]. Graefe’s Arch Clin Exp Ophthalmol, 2013, 251(1): 213-220. DOI: 10.1007/s00417-012-2052-2.
11. Ehlers JP, Modi YS, Pecen PE, et al. The discover study 3-year results: feasibility and usefulness of microscope-integrated intraoperative OCT during ophthalmic surgery[J]. Ophthalmology, 2018, 125(7): 1014-1027. DOI: 10.1016/j.ophtha.2017.12.037.
12. Ehlers JP, Griffith JF, Srivastava SK. Intraoperative optical coherence tomography during vitreoretinal surgery for dense vitreous hemorrhage in the pioneer study[J]. Retina, 2015, 35(12): 2537-2542. DOI: 10.1097/IAE.0000000000000660.
13. Ehlers JP, Goshe J, Dupps WJ, et al. Determination of feasibility and utility of microscope-integrated optical coherence tomography during ophthalmic surgery: the discover study rescan results[J]. JAMA Ophthalmol, 2015, 133(10): 1124-1132. DOI: 10.1001/jamaophthalmol.2015.2376.
14. Carrasco-Zevallos OM, Keller B, Viehland C, et al. Optical coherence tomography for retinal surgery: perioperative analysis to real-time four-dimensional image-guided surgery[J]. Invest Ophthalmol Vis Sci, 2016, 57(9): OCT37-50. DOI: 10.1167/iovs.16-19277.
15. Gabr H, Chen X, Zevallos-Carrasco OM, et al. Visualization from intraoperative swept-source microscope-integrated optical coherence tomography in vitrectomy for complications of proliferative diabetic retinopathy[J]. Retina, 2018, 38 Suppl 1: S110-120. DOI: 10.1097/IAE.0000000000002021.
16. González-Saldivar G, Chow DR. Optimizing visual performance with digitally assisted vitreoretinal surgery[J]. Ophthalmic Surg Lasers Imaging Retina, 2020, 51(4): S15-S21. DOI: 10.3928/23258160-20200401-02.
17. Zhang T, Tang W, Xu G. Comparative analysis of three-dimensional heads-up vitrectomy and traditional microscopic vitrectomy for vitreoretinal diseases[J]. Curr Eye Res, 2019, 44(10): 1080-1086. DOI: 10.1080/02713683.2019.1612443.
18. Adam MK, Thornton S, Regillo CD, et al. Minimal endoillumination levels and display luminous emittance during three-dimensional heads-up vitreoretinal surgery[J]. Retina, 2017, 37(9): 1746-1749. DOI: 10.1097/IAE.0000000000001420.
19. Kumar A, Hasan N, Kakkar P, et al. Comparison of clinical outcomes between "heads-up" 3D viewing system and conventional microscope in macular hole surgeries: a pilot study[J]. Indian J Ophthalmol, 2018, 66(12): 1816-1819. DOI: 10.4103/ijo.IJO_59_18.
20. Yata K, Fujiwara T, Yamamoto A, et al. Diabetes as risk factor of cataract: differentiation by retroillumination photography and image analysis[J]. Ophthalmic Res, 1990, 22 Suppl 1: S78-80. DOI: 10.1159/000267071.
21. Smiddy WE, Feuer W. Incidence of cataract extraction after diabetic vitrectomy[J]. Retina, 2004, 24(4): 574-581. DOI: 10.1097/00006982-200408000-00011.
22. Holekamp NM, Shui YB, Beebe D. Lower intraocular oxygen tension in diabetic patients: possible contribution to decreased incidence of nuclear sclerotic cataract[J]. Am J Ophthalmol, 2006, 141(6): 1027-1032. DOI: 10.1016/j.ajo.2006.01.016.
23. 中华医学会眼科学分会白内障及人工晶状体学组. 中国糖尿病患者白内障围手术期管理策略专家共识(2020年)[J]. 中华眼科杂志, 2020, 56(5): 337-342. DOI: 10.3760/cma.j.cn112142-20191106-00559.Cataract and Intraocular Lens Group of the Ophthalmology Branch of the Chinese Medical Association. Expert consensus on perioperative management strategies for cataract in diabetic patients in China (2020)[J]. Chin J Ophthalmol, 2020, 56(5): 337-342. DOI: 10.3760/cma.j.cn112142-20191106-00559.
24. Silva PS, Diala PA, Hamam RN, et al. Visual outcomes from pars plana vitrectomy versus combined pars plana vitrectomy, phacoemulsification, and intraocular lens implantation in patients with diabetes[J]. Retina, 2014, 34(10): 1960-1968. DOI: 10.1097/IAE.0000000000000171.
25. Ljubimov AV. Diabetic complications in the cornea[J]. Vision Res, 2017, 139: 138-152. DOI: 10.1016/j.visres.2017.03.002.
26. 中华医学会糖尿病学分会视网膜病变学组. 糖尿病视网膜病变防治专家共识[J]. 中华糖尿病杂志, 2018, 10(4): 241-247. DOI: 10.3760/cma.j.issn.1674-5809.2018.04.001.Retinopathy Group of Diabetes Branch of Chinese Medical Association. Expert consensus on prevention and treatment of diabetic retinopathy[J]. Chin J Diabetes Mellitus, 2018, 10(4): 241-247. DOI: 10.3760/cma.j.issn.1674-5809.2018.04.001.

Chinese Journal of Ocular Fundus Diseases

Improving surgical efficacy of proliferative diabetic retinopathy continuously by paying attention to the basis and keeping pace with the times

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