Article

Anterior retinal cryotherapy in diabetic vitreous hemorrhage.

American Journal of Ophthalmology (Impact Factor: 4.02). 10/1985; 100(3):440-4.
Source: PubMed

ABSTRACT Recurrent vitreous hemorrhage associated with proliferative retinopathy can occur in eyes that do not satisfactorily respond to argon laser pantretinal photocoagulation. To evaluate the effect of relatively low-risk surgical intervention, we performed peripheral retinal cryopexy on 24 eyes of 23 diabetic patients with proliferative diabetic retinopathy and vitreous hemorrhage. In most cases, cryopexy followed complete or nearly complete panretinal photocoagulation which did not prevent subsequent vitreous hemorrhage. Existing vitreous hemorrhage cleared postoperatively in 23 of 24 eyes. The best corrected visual acuity improved in 15 eyes, remained unchanged in five, and worsened in four. Four postoperative anterior segment complications resolved completely within a short time. One patient, a 68-year-old woman who had had diabetes for 18 years, postoperatively had a macular hole in one eye and macular edema with tractional retinal detachment in the other.

0 Bookmarks
 · 
364 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: HintergrundDie bei diabetischer Glaskörperblutung durchgeführte, zirkuläre periphere Netzhautkryokoagulation vermag zur Resorption der Blutung beizutragen. Es soll untersucht werden, inwiefern diese auch die Vitrektomienotwendigkeit senken kann. Material und MethodeWir werteten retrospektiv die Akten aller in den Jahren 1997–2000 operierten Patienten aus, die eine zirkuläre, periphere Netzhautkryokoagulation bei Glaskörperblutung im Rahmen einer proliferativen diabetischen Vitreoretinopathie erhielten. Erfasst wurden neben Alter und Geschlecht des Patienten die resorptive Kraft der Kryokoagulation, ob weiterhin Vitrektomiepflichtigkeit bestand und der Zeitpunkt einer möglicherweise nachfolgenden ppV. Der Nachuntersuchungszeitraum wurde mit mindestens 2 Monaten festgelegt. ResultateVon den im Untersuchungszeitraum bei diabetischer Glaskörperblutung durchgeführten 240 zirkulären Netzhautkryokoagulationen mussten sich 33,8% keinem glaskörperchirurgischen Eingriff mehr unterziehen. Insgesamt war bei 46,7% der eingebluteten Augen schon nach 8 Wochen eine komplette Resorption erfolgt. SchlussfolgerungDie zirkuläre Netzhautkryokoagulation stellt eine sinnvolle Behandlung dar, wenn sie bei diabetischen Glaskörperblutungen und peripherer Netzhautanlage durchgeführt wird, da der resorptive Effekt die Vitrektomiehäufigkeit deutlich mindert. BackgroundA circumferential cryocoagulation may boost resorption of vitreous bleedings. It should be examined if it is also reducing the rate of vitrectomy. Material and methodsWe retrospectively evaluated the reports of all patients who underwent cryocoagulation due to diabetic vitreous hemorrhage between 1997 and 2000. Beyond age and sex the resorption rate was examined and whether the patient is still to vitrectomize or to treat conservatively. Minimum follow up was 2 months. Results33.8% of 240 patients with vitreous hemorrhage did not need to undergo vitrectomy after cryocoagulation anymore, hemorrhage entirely resorbed in 46.7% within 8 weeks. ConclusionCircumferential retinal cryocoagulation is a useful treatment when done due to diabetic vitreous hemorrhage, because improved resorption lowers the vitrectomy rate.
    Spektrum der Augenheilkunde 01/2006; 20(5):224-226. · 0.18 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Transconjunctival anterior retinal cryotherapy (ARC) for proliferative diabetic retinopathy (PDR) in 408 eyes was reviewed retrospectively. Of 266 eyes available for analysis for treatment effect on neovascularization, 138 (52%) had reduced neovascularization at 6 months. Eighty (30%) had no change in neovascularization, and 48 (18%) had increased neovascularization at 6 months. Factors having a significant effect on reduction of neovascularization were duration of diabetes and severity of retinopathy. Of 238 eyes available for analysis for treatment effect on vitreous hemorrhage at 6 months, 118 (50%) had reduced vitreous hemorrhage, 80 (33%) had no change, and 40 (17%) had increased vitreous hemorrhage. Severity of vitreous hemorrhage significantly affected the outcome in the subgroup of eyes with both neovascularization and vitreous hemorrhage. Of the total 408 eyes in this series, at 6 months, 172 (44%) had improved visual acuity, 89 (23%) had no change, and 126 (33%) had decreased visual acuity. Retinal detachments developed in 17 eyes (4%) post-treatment, 68 eyes (17%) had significant recurrent vitreous hemorrhage, and 61 eyes (15%) eventually underwent vitrectomy.
    Ophthalmology 07/1987; 94(6):612-9. · 5.56 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the influence of peripheral 360 degrees retinal cryocoagulation on the blood-aqueous barrier of patients with retinal vascular disorders. The aqueous of 50 eyes of 50 patients with diabetic retinopathy or central vein occlusion was measured by laser flare photometry (FC-2000, Kowa) before peripheral 360 degrees retinal cryocoagulation and 1 day, 1 week, and 1 month thereafter. Mean aqueous flare values before treatment were 15.7 (+/-8.2) photon counts/ms; mean cell count was 9.8 (+/-14.8) cells/0.5 mm(3). One day after retinal cryocoagulation flare values had increased statistically significantly to a mean of 39.2 (+/-85.8) photon counts/ms, while the increase in mean cell number to 15.0 (+/-37.2) cells/0.5 mm(3) did not reach statistical significance. One week following treatment, mean flare values had dropped to 30.9 (+/-49.6) photon counts/ms and were no longer significantly elevated compared with baseline, while the mean cell count of 11.1 (+/-27.0) cells/0.5 mm(3) was now statistically significantly elevated compared with baseline. One month after treatment the flare values had decreased to a mean of 19.7 (+/-12.0) photon counts/ms, and mean cell count had decreased to 8.1 (+/-10.4) cells/0.5 mm(3); at this point neither parameter showed a statistically significant difference from baseline values. Peripheral 360 degrees retinocryocoagulation does not lead to permanent disturbance of the blood-aqueous barrier.
    Albrecht von Graæes Archiv für Ophthalmologie 03/2004; 242(2):120-4. · 1.93 Impact Factor