ObjectiveTo investigate the risk factors for neovascular glaucoma (NVG) after vitrectomy in proliferative diabetic retinopathy (PDR) patients. MethodsThree hundred and one patients (301 eyes) with PDR who underwent vitrectomy between January 2008 and December 2013 in our hospital were retrospectively evaluated. Risk factors for NVG after vitrectomy were identified by multivariate Logistic regression analysis. ResultsTwelve of 301 patients (4.0%) developed postoperative NVG in 2 to 18 months after vitrectomy. The incidence of postoperative NVG peaked in 2 to 6 months after vitrectomy (7 eyes, 58.3%). Logistic regression analysis showed that postoperative retinal detachment was a significant risk factor for postoperative NVG in eyes with PDR (P < 0.001). Eyes with postoperative retinal detachment were more likely to develop NVG after vitrectomy than those without postoperative retinal detachment (OR=17.826). Gender, age, duration of diabetes, preoperative serum creatinine levels, glycated hemoglobin levels, preoperative intraocular pressure, preoperative lens status, combined phacoemulsification surgery and tamponade were not associated with postoperative NVG (P > 0.05). ConclusionPostoperative retinal detachment is a major risk factor for NVG after vitrectomy in PDR.
Objective To investigate the risk factors associated with neovascular glaucoma (NVG) after pars plana vitrectomy (PPV) in eyes with proliferative diabetic retinopathy (PDR). Methods Retrospective study. One hundred and thirty-seven patients (137 eyes) with PDR who underwent PPV were recruited. There were 85 males and 52 females. The average age was (60.1±8.8) years old. The duration of diabetes was (10.2±3.6) years. There were 49 patients with ipsilateral carotid artery stenosis. Fifty-three eyes underwent intravitreal ranibizumab or conbercept injection before PPV. All eyes were treated with 23G standard three-port PPV. The average follow-up time after PPV was 11.5 months. Fundus fluorescein angiography (FFA) was conducted in postoperative 4-6 weeks to observe non-perfused retinal areas. Risk factors, such as ipsilateral carotid artery stenosis, the presence of non-perfusion in retina after PPV and the application of anti-vascular endothelial growth factor (VEGF) drugs before PPV, were identified by logistic regression. Results Twenty of 137 patients (14.6%) developed postoperative NVG after PPV. Ipsilateral carotid artery stenosis [odds ratio (OR) =5.048, 95% confidence interval (CI) 2.057-12.389,P=0.000] and the presence of non-perfusion in retina after PPV (OR=4.274, 95%CI 1.426-12.809,P=0.009) were significant risk factors for postoperative NVG, while the application of anti-VEGF drugs was not (OR=1.426, 95%CI 0.463-4.395,P=0.536). But the time from PPV to the onset of NVG varies significantly between the two groups of injection of anti-VEGF drugs or not (t=−4.370,P=0.000). Conclusions Risk factors associated with NVG after PPV in eyes with PDR included ipsilateral carotid artery stenosis and the presence of non-perfusion in retina after PPV. The application of anti-VEGF drugs before PPV can delay the onset of NVG in PDR eyes after vitrectomy.
ObjectiveTo explore the effects of vitrectomy on neovascular glaucoma combined with vitreous hemorrhage.MethodsSeven eyes of 7 patients with neovascular glaucoma combined with vitreous hemorrhage underwent vitrectomy combined with phacoemulsification, panretinal photocoagulation, and trabeculectomy. The preoperative visual acuity ranged from light perception to 0.2, and the mean preoperative intraocular pressure was 54 mm Hg (38-64 mm Hg)(1 mm Hg=0.133 kPa). The mean follow-up was 8 months (6-15 months).ResultsThe postoperative visual acuity ranged from light perception to 0.4, and the mean postoperative intraocular pressure was 17 mm Hg (10-30 mm Hg) which was significantly lower than preoperative one (Plt;0.05). The postoperative complications mainly included fibrosis exudates in anterior chamber (7 eyes), intraocular pressure elevation 1-2 weeks after the operation (2 eyes), and postoperative suprachoroidcavity hemorrhage (2 eyes).ConclusionVitrectomy combined with phacoemulsification, panretinal photocoagulation, and trabeculectomy may be effective procedures for some cases of neovascular glaucoma combined with vitreous hemorrhage.(Chin J Ocul Fundus Dis, 2005,21:148-149)
Objective To observe the effects of stromal cellderived factor 1alpha; (SDF-1alpha;) in secondary neovascular glaucoma (NVG) of proliferative diabetic retinopathy (PDR). Methods The vitreous specimens from 25 PDR patients (31 eyes) were collected with 13 NVG eyes and non-NVG 18 eyes. The concentrations of SDF-1alpha; and vascular endothelial growth factor (VEGF) in those specimens were measured by enzyme-linked immunosorbent assay （ELISA）. Human umbilical vein endothelial cells (HUVEC) were treated by different concentrations of SDF-1alpha;and vascular endothelial growth factor (VEGF) in vitro, and the formation of tube cavity-like structure, length of capillarylike structures and 5prime;-bromo-2prime;-deoxyuridine (BrdU) labeling of treated HUVEC were measured. Results The length of HUVEC tube-like and capillarylike structure formation in 10, 100, 1000 ng/ml SDF-1alpha; and 10 ng/ml VEGF groups were longer than that in the control group, the differences were statistically significant (P＜0.01). The A value of BrdU labeling of 10, 100, 1000 ng/ml SDF-1alpha; and 10 ng/ml VEGF groups were increased than that in the control group, the differences were statistically significant (P＜0.01). The vitreous levels of SDF-1alpha; and VEGF of NVG specimens were higher than those in the non-NVG group, the differences were statistically significant (P＜0.01). Conclusions SDF-1alpha; may promote the migration and proliferation of vascular endothelium cells, and participate in the neovascularization process in NVG patients with PDR.