Diabetic retinopathy vitreous hemorrhage

Spaide RF, Fisher YL. Intravitreal hevacizumab (Avastin) treatment of proliferative diabetic retinopathy complicated by vitreous hemorrhage. Retina 2006, 26, 275-278. 

Dittereatial Diagnosis. Differential diagnoses of disc hemorrhages include posterior vitreous detachment, diabetic retinopathy, hypertensive retinopathy, hemorrhage resulting from optic disc drusen, ischemic optic neuropathy, leukemia, and peripapillary neovascular membrane. 

Two cases of vitreous hemorrhage have been observed after retrobulbar block in patients with severe diabetic retinopathy (303). 

A heavier-than-water fluorinated silicone oil was used in the treatment of 30 selected cases of complicated retinal detachment due to proliferative vitreoretinopathy (n = 19), proliferative diabetic retinopathy with traction detachment (n = 2), giant retinal tears (n = 5), ruptured globe with retinal detachment (n = 2), massive choroidal effusion with retinal detachment (n = 1), and acute retinal necrosis with retinal detachment (n = 1) (13). Initial retinal reattachment was achieved in all cases. Complications included redetachment (n = l), cataract (n = 6), raised intraocular pressure (n = 4), hypotony (n = 4), keratopathy (n = 3), uveitis sjme-chia formation (n = 3), phthisis (n = 2), choroidal hemorrhage (n — 1), and vitreous hemorrhage n = 1). 

Chew EY, Klein ML, Murphy RP, et al.Early Treatment Diabetic Retinopathy Smdy Research Group. Effects of aspirin on vitreous/preretinal hemorrhage in patients with diabetes meUitus. Arch Ophthalmol 1995 113 52-55. 

One of the hypotheses for the development of vascular occlusion that precedes proliferative diabetic retinopathy is that disturbances in the thrombocyte aggregation lead to leukostasis and formation of microthrombosis in the retinal capillaries. Consequently, attention has been focused at treating diabetic retinopathy with inhibitors of thrombocyte aggregation. However, a prospective study has shown that acetyl salicylic acid does not reduce the development of diabetic retinopathy. Additionally, this treatment does not increase the risk of developing complications such as vitreous hemorrhage. This is important evidence since inhibitors of thrombocyte aggregation are often used to reduce the risk of the development of the macrovascular complications of the disease [12]. 

Boehm BO, Lang GK, Jehle PM et al. Octreotide reduces vitreous hemorrhage and loss of visual acuity risk in patients with high-risk proliferative diabetic retinopathy. Horm Met Res. 2001 33 300-306. 

Ghost cell glaucoma after intravitreal bevacizumab for postoperative vitreous hemorrhage following vitrectomy for proliferative diabetic retinopathy was identified in three of eight eyes in a retrospective chart review [8 ]. 

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