Enzymatic vitrectomy for diabetic retinopathy and diabetic macular edema  

作　　者：Manuel Diaz-Llopis Patricia Udaondo Jose Maria Millán J Fernando Arevalo 

机构地区：[1]Department of Ophthalmology,University and Polytechnic Hospital La Fe of Valencia,46009 Valencia,Spain [2]Department of Genetics,Hospital Universitario La Fe of Valencia,46009 Valencia,Spain [3]Retina Division,Wilmer Eye Institute,Johns Hopkins University School of Medicine,Baltimore,MD 21231,United States [4]King Khaled Eye Specialist Hospital,Riyadh 11462,Saudi Arabia

出　　处：《World Journal of Diabetes》2013年第6期319-323,共5页世界糖尿病杂志（英文版）（电子版）

摘　　要：The aim of this paper is to determine the role of enzymatic vitrectomy performed by intravitreal injection of autologous plasmin enzyme(APE)in the management of diabetic retinopathy and diabetic macular edema(DME).Diabetic patients with proliferative diabetic retinopathy or DME and evident posterior hyaloid adherence to the retinal surface were included.All cases were treated with an initial intravitreal injection of APE and reevaluated one month later,measuring changes in best-corrected visual acuity(BCVA),macular thickness and the status of the posterior hyaloid.A second APE injection was performed in cases with no evident posterior vitreous detachment(PVD)after the initial treatment.Sixty-three eyes were included in the present review.A complete PVD appeared in 38%of cases(24 eyes)after one injection of plasmin and the total increased to 51%(32 eyes)after the second injection,separated at least by one month.The central macular thickness improved in all cases(100%)and BCVA in89%.Finally,in 50%of eyes with proliferative diabetic retinopathy,a high reduction of new vessels regression was observed.Enzymatic vitrectomy could be considered a good therapeutic alternative in diabetic retinopathy and macular edema.The aim of this paper is to determine the role of enzymatic vitrectomy performed by intravitreal injection of autologous plasmin enzyme(APE)in the management of diabetic retinopathy and diabetic macular edema(DME).Diabetic patients with proliferative diabetic retinopathy or DME and evident posterior hyaloid adherence to the retinal surface were included.All cases were treated with an initial intravitreal injection of APE and reevaluated one month later,measuring changes in best-corrected visual acuity(BCVA),macular thickness and the status of the posterior hyaloid.A second APE injection was performed in cases with no evident posterior vitreous detachment(PVD)after the initial treatment.Sixty-three eyes were included in the present review.A complete PVD appeared in 38%of cases(24 eyes)after one injection of plasmin and the total increased to 51%(32 eyes)after the second injection,separated at least by one month.The central macular thickness improved in all cases(100%)and BCVA in89%.Finally,in 50%of eyes with proliferative diabetic retinopathy,a high reduction of new vessels regression was observed.Enzymatic vitrectomy could be considered a good therapeutic alternative in diabetic retinopathy and macular edema.

关 键 词：ENZYMATIC VITRECTOMY Autologous PLASMIN DIABETIC MACULAR edema DIABETIC RETINOPATHY 

分 类 号：R587.2[医药卫生—内分泌] R774.5[医药卫生—内科学]