Enzymatic vitreolysis for the treatment of tractional diabetic macular edema

Background: A new approach to address focal vitreomacular adhesion in patients with diabetic macular edema may control and stabilize diabetic macular edema with fewer anti-vascular endothelial growth factor injections. Objectives: The aim of this study was to demonstrate that diabetic macular edema...

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Main Authors: Bernardete Pessoa, João Coelho, Constança Coelho, Sílvia Monteiro, Carolina Abreu, João Figueira, Angelina Meireles, João Nuno Melo Beirão
Format: Article
Language:English
Published: SAGE Publishing 2019-08-01
Series:Therapeutic Advances in Ophthalmology
Online Access:https://doi.org/10.1177/2515841419869511
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author Bernardete Pessoa
João Coelho
Constança Coelho
Sílvia Monteiro
Carolina Abreu
João Figueira
Angelina Meireles
João Nuno Melo Beirão
author_facet Bernardete Pessoa
João Coelho
Constança Coelho
Sílvia Monteiro
Carolina Abreu
João Figueira
Angelina Meireles
João Nuno Melo Beirão
author_sort Bernardete Pessoa
collection DOAJ
description Background: A new approach to address focal vitreomacular adhesion in patients with diabetic macular edema may control and stabilize diabetic macular edema with fewer anti-vascular endothelial growth factor injections. Objectives: The aim of this study was to demonstrate that diabetic macular edema can be improved by inducing the release of a vitreomacular adhesion, with less than 2500 μm, with enzymatic vitreolysis. Methods: From a retrospective analysis of clinical records from patients with diabetic retinopathy, patients with diabetic macular edema and vitreomacular adhesion <2500 μm were selected for a single-arm prospective study. The primary endpoint was to control diabetic macular edema with fewer anti-vascular endothelial growth factor injections after an observed vitreomacular adhesion release. A statistical subanalysis was performed for the following two groups: the group with vitreomacular adhesion release (group 1) and the group without vitreomacular adhesion release (group 2). Results: A total of 23 eyes from 19 patients were included. A reduction of the median number of injections was achieved in group 1 ( p  = 0.006). Adverse events were mild and transitory. Conclusion: Release of vitreomacular adhesion <2500 μm through enzymatic vitreolysis contributed to the control and stabilization of diabetic macular edema with fewer anti-vascular endothelial growth factor injections, reducing the burden and the risks related to these invasive and frequently chronic treatments.
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spelling doaj.art-133e7d80e4614315a46a73b8ad5236672022-12-21T17:49:55ZengSAGE PublishingTherapeutic Advances in Ophthalmology2515-84142019-08-011110.1177/2515841419869511Enzymatic vitreolysis for the treatment of tractional diabetic macular edemaBernardete PessoaJoão CoelhoConstança CoelhoSílvia MonteiroCarolina AbreuJoão FigueiraAngelina MeirelesJoão Nuno Melo BeirãoBackground: A new approach to address focal vitreomacular adhesion in patients with diabetic macular edema may control and stabilize diabetic macular edema with fewer anti-vascular endothelial growth factor injections. Objectives: The aim of this study was to demonstrate that diabetic macular edema can be improved by inducing the release of a vitreomacular adhesion, with less than 2500 μm, with enzymatic vitreolysis. Methods: From a retrospective analysis of clinical records from patients with diabetic retinopathy, patients with diabetic macular edema and vitreomacular adhesion <2500 μm were selected for a single-arm prospective study. The primary endpoint was to control diabetic macular edema with fewer anti-vascular endothelial growth factor injections after an observed vitreomacular adhesion release. A statistical subanalysis was performed for the following two groups: the group with vitreomacular adhesion release (group 1) and the group without vitreomacular adhesion release (group 2). Results: A total of 23 eyes from 19 patients were included. A reduction of the median number of injections was achieved in group 1 ( p  = 0.006). Adverse events were mild and transitory. Conclusion: Release of vitreomacular adhesion <2500 μm through enzymatic vitreolysis contributed to the control and stabilization of diabetic macular edema with fewer anti-vascular endothelial growth factor injections, reducing the burden and the risks related to these invasive and frequently chronic treatments.https://doi.org/10.1177/2515841419869511
spellingShingle Bernardete Pessoa
João Coelho
Constança Coelho
Sílvia Monteiro
Carolina Abreu
João Figueira
Angelina Meireles
João Nuno Melo Beirão
Enzymatic vitreolysis for the treatment of tractional diabetic macular edema
Therapeutic Advances in Ophthalmology
title Enzymatic vitreolysis for the treatment of tractional diabetic macular edema
title_full Enzymatic vitreolysis for the treatment of tractional diabetic macular edema
title_fullStr Enzymatic vitreolysis for the treatment of tractional diabetic macular edema
title_full_unstemmed Enzymatic vitreolysis for the treatment of tractional diabetic macular edema
title_short Enzymatic vitreolysis for the treatment of tractional diabetic macular edema
title_sort enzymatic vitreolysis for the treatment of tractional diabetic macular edema
url https://doi.org/10.1177/2515841419869511
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