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Erschienen in: International Ophthalmology 4/2020

02.12.2019 | Original Paper

Intravitreal ranibizumab versus vitrectomy for recurrent vitreous haemorrhage after pars plana vitrectomy for proliferative diabetic retinopathy: a prospective study

verfasst von: Irini Chatziralli, Eleni Dimitriou, George Theodossiadis, Evgenia Bourouki, Eleni Bagli, George Kitsos, Panagiotis Theodossiadis

Erschienen in: International Ophthalmology | Ausgabe 4/2020

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Abstract

Purpose

To compare prospectively intravitreal ranibizumab treatment and pars plana vitrectomy (PPV) in patients with recurrent vitreous haemorrhage (VH) due to proliferative diabetic retinopathy (PDR), who were previously treated with PPV.

Methods

Participants in this prospective study were 37 patients (37 eyes) with PDR, previously treated with PPV. All patients presented recurrent VH and were treated with either ranibizumab (n = 18) or PPV (n = 19). All participants were examined at week 2 post-treatment and every month thereafter for 1 year. Main outcomes were the need of PPV, the rate of recurrence of VH and the change in visual acuity by the end of the 12-month follow-up.

Results

At month 12, there was statistically significant improvement in visual acuity in both groups compared to baseline, but the two groups did not differ regarding the change in visual acuity. In ranibizumab group, two patients presented recurrent VH during the follow-up and one patient needed PPV to clear the VH by month 12. In PPV group, two patients had mild recurrent VH, which cleared itself. No statistically significant difference was noticed regarding the rate of recurrent VH and the need of PPV between the two groups.

Conclusion

Intravitreal ranibizumab seems to be a safe and effective treatment alternative in patients with recurrent VH secondary to PDR, who had been previously treated with PPV.
Literatur
1.
Zurück zum Zitat Wild S, Roglic G, Green A, Sicree R, King H (2004) Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 27:1047–1053CrossRef Wild S, Roglic G, Green A, Sicree R, King H (2004) Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care 27:1047–1053CrossRef
2.
Zurück zum Zitat Antonetti DA, Klein R, Gardner TW (2012) Diabetic retinopathy. N Engl J Med 366:1227–1239CrossRef Antonetti DA, Klein R, Gardner TW (2012) Diabetic retinopathy. N Engl J Med 366:1227–1239CrossRef
3.
Zurück zum Zitat Madonna R, Balistreri CR, Geng YJ, De Caterina R (2017) Diabetic microangiopathy: pathogenetic insights and novel therapeutic approaches. Vasc Pharmacol 90:1–7CrossRef Madonna R, Balistreri CR, Geng YJ, De Caterina R (2017) Diabetic microangiopathy: pathogenetic insights and novel therapeutic approaches. Vasc Pharmacol 90:1–7CrossRef
4.
Zurück zum Zitat Malecaze F, Clamens S, Simorre-Pinatel V, Mathis A, Chollet P, Favard C, Bayard F, Plouet J (1994) Detection of vascular endothelial growth factor messenger RNA and vascular endothelial growth factor-like activity in proliferative diabetic retinopathy. Arch Ophthalmol 112:1476–1482CrossRef Malecaze F, Clamens S, Simorre-Pinatel V, Mathis A, Chollet P, Favard C, Bayard F, Plouet J (1994) Detection of vascular endothelial growth factor messenger RNA and vascular endothelial growth factor-like activity in proliferative diabetic retinopathy. Arch Ophthalmol 112:1476–1482CrossRef
5.
Zurück zum Zitat Xu Y, Cheng Q, Yang B, Yu S, Xu F, Lu L, Liang X (2015) Increased sCD200 levels in vitreous of patients with proliferative diabetic retinopathy and its correlation with VEGF and proinflammatory cytokines. Invest Ophthalmol Vis Sci 56:6565–6572CrossRef Xu Y, Cheng Q, Yang B, Yu S, Xu F, Lu L, Liang X (2015) Increased sCD200 levels in vitreous of patients with proliferative diabetic retinopathy and its correlation with VEGF and proinflammatory cytokines. Invest Ophthalmol Vis Sci 56:6565–6572CrossRef
6.
Zurück zum Zitat Yeh PT, Yang CM, Yang CH, Huang JS (2005) Cryotherapy of the anterior retina and sclerotomy sites in diabetic vitrectomy to prevent recurrent vitreous hemorrhage: an ultrasound biomicroscopy study. Ophthalmology 112:2095–2102CrossRef Yeh PT, Yang CM, Yang CH, Huang JS (2005) Cryotherapy of the anterior retina and sclerotomy sites in diabetic vitrectomy to prevent recurrent vitreous hemorrhage: an ultrasound biomicroscopy study. Ophthalmology 112:2095–2102CrossRef
7.
Zurück zum Zitat Schachat AP, Oyakawa RT, Michels RG, Rice TA (1983) Complications of vitreous surgery for diabetic retinopathy. II. Postoperative complications. Ophthalmology 90:522–530CrossRef Schachat AP, Oyakawa RT, Michels RG, Rice TA (1983) Complications of vitreous surgery for diabetic retinopathy. II. Postoperative complications. Ophthalmology 90:522–530CrossRef
8.
Zurück zum Zitat Soto-Pedre E, Hernaez-Ortega MC, Vazquez JA (2005) Risk factors for postoperative hemorrhage after vitrectomy for diabetic retinopathy. Ophthalmic Epidemiol 12:335–341CrossRef Soto-Pedre E, Hernaez-Ortega MC, Vazquez JA (2005) Risk factors for postoperative hemorrhage after vitrectomy for diabetic retinopathy. Ophthalmic Epidemiol 12:335–341CrossRef
9.
Zurück zum Zitat Brown GC, Tasman WS, Benson WE, McNamara JA, Eagle RC Jr. (1992) Reoperation following diabetic vitrectomy. Arch Ophthalmol 110:506–510CrossRef Brown GC, Tasman WS, Benson WE, McNamara JA, Eagle RC Jr. (1992) Reoperation following diabetic vitrectomy. Arch Ophthalmol 110:506–510CrossRef
10.
Zurück zum Zitat Yan H, Cui J, Lu Y, Yu J, Chen S, Xu Y (2010) Reasons for and management of postvitrectomy vitreous hemorrhage in proliferative diabetic retinopathy. Curr Eye Res 35:308–313CrossRef Yan H, Cui J, Lu Y, Yu J, Chen S, Xu Y (2010) Reasons for and management of postvitrectomy vitreous hemorrhage in proliferative diabetic retinopathy. Curr Eye Res 35:308–313CrossRef
11.
Zurück zum Zitat Hershberger VS, Augsburger JJ, Hutchins RK, Raymond LA, Krug S (2004) Fibrovascular ingrowth at sclerotomy sites in vitrectomized diabetic eyes with recurrent vitreous hemorrhage: ultrasound biomicroscopy findings. Ophthalmology 111:1215–1221CrossRef Hershberger VS, Augsburger JJ, Hutchins RK, Raymond LA, Krug S (2004) Fibrovascular ingrowth at sclerotomy sites in vitrectomized diabetic eyes with recurrent vitreous hemorrhage: ultrasound biomicroscopy findings. Ophthalmology 111:1215–1221CrossRef
12.
Zurück zum Zitat Kim DY, Kim JG, Kim YJ, Joe SG, Lee JY (2014) Ultra-widefield fluorescein angiographic findings in patients with recurrent vitreous hemorrhage after diabetic vitrectomy. Invest Ophthalmol Vis Sci 55:7040–7046CrossRef Kim DY, Kim JG, Kim YJ, Joe SG, Lee JY (2014) Ultra-widefield fluorescein angiographic findings in patients with recurrent vitreous hemorrhage after diabetic vitrectomy. Invest Ophthalmol Vis Sci 55:7040–7046CrossRef
13.
Zurück zum Zitat Bhavsar AR, Torres K, Glassman AR, Jampol LM, Kinyoun JL, Diabetic Retinopathy Clinical Research Network (2014) Evaluation of results 1 year following short-term use of ranibizumab for vitreous hemorrhage due to proliferative diabetic retinopathy. JAMA Ophthalmol 132:889–890CrossRef Bhavsar AR, Torres K, Glassman AR, Jampol LM, Kinyoun JL, Diabetic Retinopathy Clinical Research Network (2014) Evaluation of results 1 year following short-term use of ranibizumab for vitreous hemorrhage due to proliferative diabetic retinopathy. JAMA Ophthalmol 132:889–890CrossRef
14.
Zurück zum Zitat Yeh PT, Yang CH, Yang CM (2011) Intravitreal bevacizumab injection for recurrent vitreous haemorrhage after diabetic vitrectomy. Acta Ophthalmol 89:634–640CrossRef Yeh PT, Yang CH, Yang CM (2011) Intravitreal bevacizumab injection for recurrent vitreous haemorrhage after diabetic vitrectomy. Acta Ophthalmol 89:634–640CrossRef
15.
Zurück zum Zitat Gross JG, Glassman AR, Jampol LM, Inusah S, Aiello LP, Antoszyk AN, Baker CW, Berger BB, Bressler NM, Browning D, Elman MJ, Ferris FL 3rd, Friedman SM, Marcus DM, Melia M, Stockdale CR, Sun JK, Beck RW (2015) Panretinal photocoagulation vs intravitreous Ranibizumab for proliferative diabetic retinopathy: a randomized clinical trial. JAMA 314:2137–2146CrossRef Gross JG, Glassman AR, Jampol LM, Inusah S, Aiello LP, Antoszyk AN, Baker CW, Berger BB, Bressler NM, Browning D, Elman MJ, Ferris FL 3rd, Friedman SM, Marcus DM, Melia M, Stockdale CR, Sun JK, Beck RW (2015) Panretinal photocoagulation vs intravitreous Ranibizumab for proliferative diabetic retinopathy: a randomized clinical trial. JAMA 314:2137–2146CrossRef
16.
Zurück zum Zitat Wu B, Wu H, Liu X, Lin H, Li J (2014) Ranibizumab versus bevacizumab for ophthalmic diseases related to neovascularisation: a meta-analysis of randomised controlled trials. PLoS ONE 9:e101253CrossRef Wu B, Wu H, Liu X, Lin H, Li J (2014) Ranibizumab versus bevacizumab for ophthalmic diseases related to neovascularisation: a meta-analysis of randomised controlled trials. PLoS ONE 9:e101253CrossRef
17.
Zurück zum Zitat Schmucker C, Ehlken C, Agostini HT, Antes G, Ruecker G, Lelgemann M, Loke YK (2012) A safety review and meta-analyses of bevacizumab and ranibizumab: off-label versus gold standard. PLoS ONE 7:e42701CrossRef Schmucker C, Ehlken C, Agostini HT, Antes G, Ruecker G, Lelgemann M, Loke YK (2012) A safety review and meta-analyses of bevacizumab and ranibizumab: off-label versus gold standard. PLoS ONE 7:e42701CrossRef
18.
Zurück zum Zitat Holladay JT (1997) Proper method for calculating average visual acuity. J Refract Surg 13:388–391PubMed Holladay JT (1997) Proper method for calculating average visual acuity. J Refract Surg 13:388–391PubMed
19.
Zurück zum Zitat Simunovic MP, Maberley DA (2015) Anti-vascular endothelial growth factor therapy for proliferative diabetic retinopathy: a systematic review and meta-analysis. Retina 35:1931–1942CrossRef Simunovic MP, Maberley DA (2015) Anti-vascular endothelial growth factor therapy for proliferative diabetic retinopathy: a systematic review and meta-analysis. Retina 35:1931–1942CrossRef
20.
Zurück zum Zitat Ruiz-Moreno JM, Montero JA, Lugo F, Amat P, Staicu C (2008) Intravitreal bevacizumab in recurrent diabetic vitreous haemorrhage after vitrectomy. Acta Ophthalmol 86:231–232CrossRef Ruiz-Moreno JM, Montero JA, Lugo F, Amat P, Staicu C (2008) Intravitreal bevacizumab in recurrent diabetic vitreous haemorrhage after vitrectomy. Acta Ophthalmol 86:231–232CrossRef
21.
Zurück zum Zitat Ferenchak K, Duval R, Cohen JA, MacCumber MW (2014) Intravitreal bevacizumab or postoperative recurrent vitreous hemorrhage after vitrectomy for proliferative diabetic retinopathy. Retina 34:1177–1181CrossRef Ferenchak K, Duval R, Cohen JA, MacCumber MW (2014) Intravitreal bevacizumab or postoperative recurrent vitreous hemorrhage after vitrectomy for proliferative diabetic retinopathy. Retina 34:1177–1181CrossRef
22.
Zurück zum Zitat Moreno MR, Tabitha TS, Nirmal J, Radhakrishnan K, Yee CH, Lim S, Venkatraman S, Agrawal R (2016) Study of stability and biophysical characterization of ranibizumab and aflibercept. Eur J Pharm Biopharm 108:156–167CrossRef Moreno MR, Tabitha TS, Nirmal J, Radhakrishnan K, Yee CH, Lim S, Venkatraman S, Agrawal R (2016) Study of stability and biophysical characterization of ranibizumab and aflibercept. Eur J Pharm Biopharm 108:156–167CrossRef
23.
Zurück zum Zitat Zhang L, Wang W, Gao Y, Lan J, Xie L (2016) The efficacy and safety of current treatments in diabetic macular edema: a systematic review and network meta-analysis. PLoS ONE 11:e0159553CrossRef Zhang L, Wang W, Gao Y, Lan J, Xie L (2016) The efficacy and safety of current treatments in diabetic macular edema: a systematic review and network meta-analysis. PLoS ONE 11:e0159553CrossRef
24.
Zurück zum Zitat Avery RL, Gordon GM (2016) systemic safety of prolonged monthly anti-vascular endothelial growth factor therapy for diabetic macular edema: a systematic review and meta-analysis. JAMA Ophthalmol 134:21–29CrossRef Avery RL, Gordon GM (2016) systemic safety of prolonged monthly anti-vascular endothelial growth factor therapy for diabetic macular edema: a systematic review and meta-analysis. JAMA Ophthalmol 134:21–29CrossRef
25.
Zurück zum Zitat Chelala E, Nehme J, El Rami H, Aoun R, Dirani A, Fadlallah A, Jalkh A (2018) Efficacy of intravitreal ranibizumab injections in the treatment of vitreous hemorrhage related to proliferative diabetic retinopathy. Retina 38:1127–1133CrossRef Chelala E, Nehme J, El Rami H, Aoun R, Dirani A, Fadlallah A, Jalkh A (2018) Efficacy of intravitreal ranibizumab injections in the treatment of vitreous hemorrhage related to proliferative diabetic retinopathy. Retina 38:1127–1133CrossRef
26.
Zurück zum Zitat Diabetic Retinopathy Clinical Research Network (2013) Randomized clinical trial evaluating intravitreal ranibizumab or saline for vitreous hemorrhage from proliferative diabetic retinopathy. JAMA Ophthalmol 131:283–293CrossRef Diabetic Retinopathy Clinical Research Network (2013) Randomized clinical trial evaluating intravitreal ranibizumab or saline for vitreous hemorrhage from proliferative diabetic retinopathy. JAMA Ophthalmol 131:283–293CrossRef
27.
Zurück zum Zitat Arevalo JF, Maia M, Flynn HW Jr, Saravia M, Avery RL, Wu L, Eid Farah M, Pieramici DJ, Berrocal MH, Sanchez JG (2008) Tractional retinal detachment following intravitreal bevacizumab (Avastin) in patients with severe proliferative diabetic retinopathy. Br J Ophthalmol 92:213–216CrossRef Arevalo JF, Maia M, Flynn HW Jr, Saravia M, Avery RL, Wu L, Eid Farah M, Pieramici DJ, Berrocal MH, Sanchez JG (2008) Tractional retinal detachment following intravitreal bevacizumab (Avastin) in patients with severe proliferative diabetic retinopathy. Br J Ophthalmol 92:213–216CrossRef
28.
Zurück zum Zitat Lee SJ, Koh HJ (2009) Enlargement of the foveal avascular zone in diabetic retinopathy after adjunctive intravitreal bevacizumab (avastin) with pars plana vitrectomy. J Ocul Pharmacol Ther 25:173–174CrossRef Lee SJ, Koh HJ (2009) Enlargement of the foveal avascular zone in diabetic retinopathy after adjunctive intravitreal bevacizumab (avastin) with pars plana vitrectomy. J Ocul Pharmacol Ther 25:173–174CrossRef
29.
Zurück zum Zitat Ficker L, Meredith TA, Gardner S, Wilson LA (1990) Cefazolin levels after intravitreal injection. Effects of inflammation and surgery. Invest Ophthalmol Vis Sci 31:502–505PubMed Ficker L, Meredith TA, Gardner S, Wilson LA (1990) Cefazolin levels after intravitreal injection. Effects of inflammation and surgery. Invest Ophthalmol Vis Sci 31:502–505PubMed
30.
Zurück zum Zitat Kakinoki M, Sawada O, Sawada T, Saishin Y, Kawamura H, Ohji M (2012) Effect of vitrectomy on aqueous VEGF concentration and pharmacokinetics of bevacizumab in macaque monkeys. Invest Ophthalmol Vis Sci 53:5877–5880CrossRef Kakinoki M, Sawada O, Sawada T, Saishin Y, Kawamura H, Ohji M (2012) Effect of vitrectomy on aqueous VEGF concentration and pharmacokinetics of bevacizumab in macaque monkeys. Invest Ophthalmol Vis Sci 53:5877–5880CrossRef
Metadaten
Titel
Intravitreal ranibizumab versus vitrectomy for recurrent vitreous haemorrhage after pars plana vitrectomy for proliferative diabetic retinopathy: a prospective study
verfasst von
Irini Chatziralli
Eleni Dimitriou
George Theodossiadis
Evgenia Bourouki
Eleni Bagli
George Kitsos
Panagiotis Theodossiadis
Publikationsdatum
02.12.2019
Verlag
Springer Netherlands
Erschienen in
International Ophthalmology / Ausgabe 4/2020
Print ISSN: 0165-5701
Elektronische ISSN: 1573-2630
DOI
https://doi.org/10.1007/s10792-019-01244-z

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