Proliferative diabetic retinopathy

Patel B, Hiscott P, Chatteris D, Mather J, McLeod D, Boulton M 1994 Retinal and preretinal localisation of epidermal growth factor, transforming growth factor alpha, and their receptor in proliferative diabetic retinopathy. Br J Ophthalmol 78 714—718 Pittendrigh CS 1993 Temporal organization reflections of a Darwinian clock-watcher. jAnnu... 

J.S. Rinkoff, E. de Juan Jr, B.W. Me Cuen, Silicone oil of retinal detachment with advanced proliferative vitreoretinopathy following failed vitrectomy for proliferative diabetic retinopathy. Am. J. Ophthalmol. 101 (1986) 181-186. 

K. Heimann, B. Dalh, S. Dimopoulos, K.D. Lemmen, Pars plana vitrectomy and silicone oil injection in proliferative diabetic retinopathy, Graefes Arch. Clin. Exp. Ophthalmol. 227 (1989) 152-156. 

Rosenlund EF, Haakens K, Brinchmann-Hansen O, Dahl-Jorgensen K, Hanssen KF. Transient proliferative diabetic retinopathy during intensified insulin treatment. Am J Ophthalmol 1988 105(6) 618-25. 

Kitzmiller JL, Main E, Ward B, Theiss T, Peterson DL. Insulin lispro and the development of proliferative diabetic retinopathy during pregnancy. Diabetes Care 1999 22(5) 874-6. 

Adamis AP, Miller JW, Bernal MT, Damico DJ, Folkman J, Yeo TK, Yeo KT. 1994. Increased vascular endothelial growth factor levels in the vitreous of eyes with proliferative diabetic retinopathy. Am J Ophthalmol 118 445-450. 

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

Pathologic neovascularization of the retina is central to several debilitating ocular diseases including proliferative diabetic retinopathy (PDR), age-related macular degeneration (AMD), and retinopathy of prematurity (ROP). Diabetic retinopathy (primarily retinal NV) and the wet form of AMD (primarily choroidal NY) are the leading causes of blindness in developed countries. 

Effective, long lasting treatment of retinal neovascular disorders, including proliferative diabetic retinopathy and proliferative AMD, remains one of the greatest challenges in ophthalmology today. The number of individuals suffering from diabetes has... 

Two years ago she developed hypertension, which was treated with ben-droflumethiazide, 5mg daily. At that time, her blood urea level was 8.2 mmol/L, serum creatinine was 80 pmol/L, and dipstick urinalysis was negative for protein. She was also noted to have non-proliferative diabetic retinopathy, and given a course of laser treatment. 

The use of intravitreal corticosteroids is presently being explored in the treatment options of exudative macular degeneration and proliferative diabetic retinopathy. The rational fc>r their use stems from the feet that corticosteroids as a drug class represent one of the most... 

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). 

Ambati J, Chalam KV, Chawla DK, D Angio CT, Guillet EG, et al. 1997. Elevated gamma-aminobutyric acid, glutamate, and vascular endothelial growth factor levels in the vitreous of patients with proliferative diabetic retinopathy. Arch Ophthalmol 115 1161-1166. 

Burgos R, Mateo C, Canton A, Hernandez C, Mesa J, et al. 2000. Vitreous levels of IGF-I, IGF binding protein 1, and IGF binding protein 3 in proliferative diabetic retinopathy A case-control study. Diabetes Care 23 80-83. 

Another effect of disease states such as diabetes and proliferative diabetic retinopathy is an increase in the vitreous protein concentration, which may be partly, but not entirely, due to vascular leakage (102,103). Thus, the decreased permeability barrier (systemic to vitreous) and increased potential for protein binding within the vitreous will tend to increase vitreous drug concentrations. The increased intravitreal drug concentration is opposed by the decreased permeability barrier (vitreous to serum) that may enhance vitreous elimination. The process is further complicated by the effects of ocular diseases on active transport mechanisms. 

Miller JW, Adamis AP, Aiello LP. Vascular endothelial growth factor in ocular neovascularization and proliferative diabetic retinopathy. Diabetes Metab Rev 1997 13 37-50. 

The use of intravitreal corticosteroids was first popularized by Machemer in 1979 (33) in an effort to halt cellular proliferation after retinal detachment surgery, and Graham (34), McCuen (35), Tano (36), and others have studied its use in both animal models and humans. In contrast to other corticosteroids with short half-lives following intravitreal injection, triamcinolone acetonide is an effective and well-tolerated (35,37) agent for intravitreal injection in conditions such as uveitis (38,39), macular edema secondary to ocular trauma or retinal vascular disease (40), proliferative diabetic retinopathy (41), intraocular proliferation such as proliferative vitreoretinopathy (42), and choroidal neovascularization from AMD (43,44). 

Jonas et al. (45) found no significant effect of intravitreal triamcinolone on blood glucose in a series of diabetic patients treated with intravitreal triamcinolone after pars plana vitrectomy for proliferative diabetic retinopathy. 

Intravitreal triamcinolone acetonide use has increased recently following case series of successful treatment of edema due to various etiologies as well as choroidal neovascularization. It has been advocated for the treatment of macular edema associated with diabetes (54), uveitis (38,39), and central retinal vein occlusion (55). In addition, it has been proposed as adjunctive treatment for proliferative diabetic retinopathy (41) and exudative AMD (43,44). 

Jonas JB, Hayler JK, Sofker A, Panda-Jonas S. Intravitreal injection of crystalline cortisone as adjunctive treatment of proliferative diabetic retinopathy. Am J Ophthalmol 2001 131 (4) 468—471. 

Heparin may prevent postoperative fibrin formation in eyes undergoing surgery for complications of proliferative diabetic retinopathy, proliferative vitreoretino-pathy, and glaucoma filtration surgery. 

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]. 

More than 50 years ago, a patient was observed with severe proliferative diabetic retinopathy that regressed totally after infarction of the hypophysis while giving birth [13]. This stimulated the hypothesis that there might be a relation between the hormone production in the pituitary gland notably growth hormone, and the development of diabetic... 

VFGF is a growth factor that increases the permeability of retinal vessels and stimulates the proliferation of vascular endothelial cells in proliferative diabetic retinopathy. VEGF is synthesized as... 

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. 

Avery RL, Pearlman J, Pieramici DJ et al. Intravitreal bevacizumab (Avastin) in the treatment of proliferative diabetic retinopathy. Ophthalmology 2006 113( 10) 1695-1705.e6. 

For instance, using this device, remotely operated dmg transport to ex vivo human eye tissue was reported for treatment of ocular diseases such as proliferative diabetic retinopathy... 

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