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Dong Yoon Kim, Yoon Jeon Kim, Soo Guen Joe, Joo Yong Lee, June-Gone Kim; Ultra widefield fluorescein angiographic findings in patient with recurrent vitreous hemorrhage after diabetic vitrectomy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):242.
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To analyze the difference in ultra-widefield fluorescein angiographic findings between patients with recurrent post vitrectomy diabetic vitreous hemorrhage (PVDVH) and patients with no post vitrectomy diabetic vitreous hemorrhage (NPVDVH).
Retrospective review was conducted to the patients who were underwent vitrectomy for diabetic vitreous hemorrhage. Patients were categorized as PVDVH when vitreous hemorrhage was recurred after diabetic vitrectomy. Age-matched control patients who underwent diabetic vitrectomy and did not recurred vitreous hemorrhage after vitrectomy were assigned to NPVDVH. Baseline characteristics such as best corrected visual acuity (BCVA), follow-up duration, HbA1C level were compared between groups. And by using ultra-widefield fluorescein angiography, peripheral angiographic findings such as peripheral neovascularization, non-perfusion and late peripheral vascular leakage were analyzed.
Seventeen eyes were PVDVH and 24 eyes were NPVDVH. BCVA at preoperative, 3 month after postoperative and final visit were not different between two groups. Follow-up duration and HbA1C level were not significantly different. Mean intravitreal bevacizumab injections for PVDVH were 7.24 ± 5.95. The rate of peripheral neovascularization was significantly different between groups (PVDVH ; 35.5%, NPVDVH ; 8.3%, p =0.049). The rate of peripheral non-perfusion was significantly greater in PVDVH than in NPVDVH (PVDVH ; 76.5%, NPVDVH ; 37.5%, p =0.014). And the rate of late peripheral vascular leakage was also significantly greater in PVDVH than in NPVDVH (PVDVH ; 88.2%, NPVDVH ; 29.2%, p<0.001).
Compared with diabetic vitrectomized eyes that did not recurred after diabetic vitrectomy, PVDVH eyes had higher rate of peripheral neovascularization, peripheral non-perfusion and late peripheral vascular leakage. Considering the high rate of peripheral neovascularization, late peripheral vascular leakage and peripheral non-perfusion, increased vascular endothelial growth factor (VEGF) level might be associated with post vitrectomy diabetic vitreous hemorrhage.
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