Ординатура / Офтальмология / Английские материалы / Diabetes and Ocular Disease Past, Present, and Future Therapies 2nd edition_Scott, Flynn, Smiddy_2009
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294 Diabetes and Ocular Disease
34.Reichard P, Nilsson BY, Rosenqvist U. The effect of long-term intensified insulin treatment on the development of microvascular complications of diabetes mellitus. N Engl J Med. 1993;329:304–309.
35.Reichard P, Pihl M, Rosenqvist U, Sule J. Complications in IDDM are caused by elevated blood glucose level: the Stockholm Diabetes Intervention Study (SDIS) at 10-year follow up. Diabetologia. 1996;39:1483–1488.
36.The Diabetes Control and Complications Trial Research Group. Early worsening of diabetic retinopathy in the Diabetes Control and Complications Trial. Arch Ophthalmol. 1998;116:874–886.
37.Egger M, Davey Smith G, Stettler C, Diem P. Risk of adverse effects of intensified treatment in insulin-dependent diabetes mellitus: a meta-analysis. Diabet Med. 1997;14: 919–928.
38.van Leiden HA, Dekker JM, Moll AC, et al. Blood pressure, lipids, and obesity are associated with retinopathy: the hoorn study. Diabetes Care. 2002;25:1320–1325.
39.Wong TY, Mitchell P. The eye in hypertension. Lancet. 2007;369:614.
40.Klein R, Klein BE, Moss SE, Davis MD, DeMets DL. Is blood pressure a predictor of the incidence or progression of diabetic retinopathy? Arch Intern Med. 1989;149: 2427–2432.
41.Klein R, Moss SE, Klein BE, Davis MD, DeMets DL. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XI. The incidence of macular edema. Ophthalmology. 1989;96:1501–1510.
42.Matthews DR, Stratton IM, Aldington SJ, Holman RR, Kohner EM, UK Prospective Diabetes Study Group. Risks of progression of retinopathy and vision loss related to tight blood pressure control in type 2 diabetes mellitus: UKPDS 69. Arch Ophthalmol. 2004;122:1631–1640.
43.Estacio RO, Jeffers BW, Gifford N, Schrier RW. Effect of blood pressure control on diabetic microvascular complications in patients with hypertension and type 2 diabetes. Diabetes Care. 2000;23(Suppl 2):B54–B64.
44.Schrier RW, Estacio RO, Esler A, Mehler P. Effects of aggressive blood pressure control in normotensive type 2 diabetic patients on albuminuria, retinopathy and strokes. Kidney Int. 2002;61:1086–1097.
45.Chaturvedi N, Sjolie AK, Stephenson JM, et al. Effect of lisinopril on progression of retinopathy in normotensive people with type 1 diabetes. The EUCLID Study Group. EURODIAB Controlled Trial of Lisinopril in Insulin-Dependent Diabetes Mellitus. Lancet. 1998;351:28–31.
46.Patel A, ADVANCE Collaborative Group, MacMahon S, et al. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet. 2007;370:829–840.
47.Schrier RW, Estacio RO, Jeffers B. Appropriate Blood Pressure Control in NIDDM (ABCD) Trial. Diabetologia. 1996;39:1646–1654.
48.Larsen M, Hommel E, Parving HH, Lund-Andersen H. Protective effect of captopril on the blood-retina barrier in normotensive insulin-dependent diabetic patients with nephropathy and background retinopathy. Graefes Arch Clin Exp Ophthalmol. 1990;228:505–509.
49.ADVANCE Collaborative Group. ADVANCE—Action in Diabetes and Vascular Disease: patient recruitment and characteristics of the study population at baseline. Diabet Med. 2005;22:882–888.
Management of Diabetic Retinopathy |
295 |
50.Knudsen ST, Bek T, Poulsen PL, Hove MN, Rehling M, Mogensen CE. Effects of losartan on diabetic maculopathy in type 2 diabetic patients: a randomized, doublemasked study. J Intern Med. 2003;254:147–158.
51.Sjolie AK, Klein R, Porta M, Orchard T, Fuller J, Parving HH, et al. Effect of candesartan on progression and regression of retinopathy in type 2 diabetes (DIRECTProtect 2): a randomised placebo-controlled trial. Lancet. 2008;372:1385–1393.
52.Chaturvedi N, Porta M, Klein R, Orchard T, Fuller J, Parving HH, et al. Effect of candesartan on prevention (DIRECT-Prevent 1) and progression (DIRECT-Protect
1)of retinopathy in type 1 diabetes: randomised, placebo-controlled trials. Lancet 2008;372:1394–1402.
53.Chew EY, Ambrosius WT, Howard LT, et al. Rationale, design, and methods of the Action to Control Cardiovascular Risk in Diabetes Eye Study (ACCORD-EYE). Am J Cardiol. 2007;99:103i–111i.
54.Klein R, Sharrett AR, Klein BE, et al. The association of atherosclerosis, vascular risk factors, and retinopathy in adults with diabetes: the atherosclerosis risk in communities study. Ophthalmology. 2002;109:1225–1234.
55.Chew EY, Klein ML, Ferris FL, et al. Association of elevated serum lipid levels with retinal hard exudate in diabetic retinopathy. Early Treatment Diabetic Retinopathy Study (ETDRS) Report 22. Arch Ophthalmol. 1996;114:1079–1084.
56.Sen K, Misra A, Kumar A, Pandey RM. Simvastatin retards progression of retinopathy in diabetic patients with hypercholesterolemia. Diabetes Res Clin Pract. 2002;56:1–11.
57.Cullen JF, Town SM, Campbell CJ. Double-blind trial of Atromid-S in exudative diabetic retinopathy. Trans Ophthalmol Soc UK. 1974;94:554–562.
58.Keech A, Simes RJ, Barter P, et al. Effects of long-term fenofibrate therapy on car-
diovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): randomised controlled trial. Lancet. 2005;366:1849–1861.
59. Early Treatment Diabetic Retinopathy Study Research Group. Effects of aspirin treatment on diabetic retinopathy. ETDRS report number 8. Ophthalmology 1991;98:757–765.
60.Chew EY, Klein ML, Murphy RP, Remaley NA, Ferris FL. Effects of aspirin on vitreous/preretinal hemorrhage in patients with diabetes mellitus. Early Treatment Diabetic Retinopathy Study report no. 20. Arch Ophthalmol. 1995;113:52–55.
61.The DAMAD Study Group. Effect of aspirin alone and aspirin plus dipyridamole in early diabetic retinopathy. A multicenter randomized controlled clinical trial. Diabetes. 1989;38:491–498.
62.The TIMAD Study Group. Ticlopidine treatment reduces the progression of nonproliferative diabetic retinopathy. Arch Ophthalmol. 1990;108:1577–1583.
63.The PKC-DRS Study Group. The effect of ruboxistaurin on visual loss in patients with moderately severe to very severe nonproliferative diabetic retinopathy: initial results of the Protein Kinase C beta Inhibitor Diabetic Retinopathy Study (PKC-DRS) multicenter randomized clinical trial. Diabetes. 2005;54:2188–2197.
64.PKC-DMES Study Group. Effect of ruboxistaurin in patients with diabetic macular edema: thirty-six month results of the randomized PKC-DMES clinical trial. Arch Ophthalmol. 2007;124:318–324.
65.Sorbinil Retinopathy Trial Research Group. A randomized trial of sorbinil, an aldose reductase inhibitor, in diabetic retinopathy. Arch Ophthalmol. 1990;108: 1234–1244.
296 Diabetes and Ocular Disease
66.Gardner TW, Sander B, Larsen ML, et al. An extension of the Early Treatment Diabetic Retinopathy Study (ETDRS) system for grading of diabetic macular edema in the Astemizole Retinopathy Trial. Curr Eye Res. 2006;31:535–547.
67.Grant MB, Mames RN, Fitzgerald C, et al. The efficacy of octreotide in the therapy of severe nonproliferative and early proliferative diabetic retinopathy: a randomized controlled study. Diabetes Care. 2000;23:504–509.
68.Thomason MJ, Colhoun HM, Livingstone SJ, et al. Baseline characteristics in the Collaborative A to Rvastatin Diabetes Study (CARDS) in patients with Type 2 diabetes. Diabet Med. 2004;21:901–905.
69.Colhoun HM, Betteridge DJ, Durrington PN, et al. Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial. Lancet. 2004;364:685–696.
70.Knopp RH, d’Emden M, Smilde JG, Pocock SJ. Efficacy and safety of atorvastatin in the prevention of cardiovascular end points in subjects with type 2 diabetes: the Atorvastatin Study for Prevention of Coronary Heart Disease Endpoints in non-insu- lin-dependent diabetes mellitus (ASPEN). Diabetes Care. 2006;29:1478–1485.
71.PKC-DRS2 Group, Aiello LP, Davis MD, et al. Effect of ruboxistaurin on visual loss in patients with diabetic retinopathy. Ophthalmology. 2006;113:2221–2230.
72.Aiello LP, Davis MD, Milton RC, et al. Protein kinase C inhibitor trials: diabetic retinopathy & diabetic macular edema: University of Wisconsin - Madison; 2005. Available at: http://eyephoto.ophth.wisc.edu/PresentationsPublications/PKCInhibitorTrials.pdf (accessed 2006 Apr 4).
73.Ray BS, Pazianos AG, Greenberg E, Peretz WL, McLean JM. Pituitary ablation for diabetic retinopathy. I. Results of hypophysectomy. (A ten-year evaluation). JAMA. 1968;203:79–84.
74.Hardy J, Ciric IS. Selective anterior hypophysectomy in the treatment of diabetic retinopathy. A transsphenoidal microsurgical technique. JAMA. 1968;203:73–78.
75.Sönksen PH, Russell-Jones D, Jones RH. Growth hormone and diabetes mellitus. A review of sixty-three years of medical research and a glimpse into the future? Horm Res. 1993;40:68–79.
76.Kirkegaard C, Nørgaard K, Snorgaard O, Bek T, Larsen M, Lund-Andersen H. Effect of one year continuous subcutaneous infusion of a somatostatin analogue, octreotide, on early retinopathy, metabolic control and thyroid function in Type I (insulin-depen- dent) diabetes mellitus. Acta Endocrinol (Copenh). 1990;122:766–772.
77.Available at; http://clinicaltrials.gov/ct/show/NCT00248157. (Accessed October 2006.)
78.Available at; http://clinicaltrials.gov/ct/show/NCT00248131. (Accessed October 2006.)
79.Mohamed Q, Wong TY. Emerging drugs for diabetic retinopathy. Expert Opin Emerg Drugs. December 2008;13(4):675–694.
80.The Diabetic Retinopathy Study Research Group. Photocoagulation treatment of proliferative diabetic retinopathy: the second report of diabetic retinopathy study findings. Ophthalmology. 1978;85:82–106.
81.The Diabetic Retinopathy Study Research Group. Photocoagulation treatment of proliferative diabetic retinopathy. Clinical application of Diabetic Retinopathy Study (DRS) findings, DRS Report Number 8. Ophthalmology. 1981;88:583–600.
82.Early Treatment Diabetic Retinopathy Study Research Group. Early Treatment Diabetic Retinopathy Study design and baseline patient characteristics. ETDRS report number 7. Ophthalmology. 1991;98:741–756.
Management of Diabetic Retinopathy |
297 |
83.Rohan TE, Frost CD, Wald NJ. Prevention of blindness by screening for diabetic retinopathy: a quantitative assessment. BMJ. 1989;299:1198–1201.
84.Early Treatment Diabetic Retinopathy Study Research Group. Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Ophthalmology. 1991;98: 766–785.
85.Flynn HW, Chew EY, Simons BD, Barton FB, Remaley NA, Ferris FL. Pars plana vitrectomy in the Early Treatment Diabetic Retinopathy Study. ETDRS report number 17. The Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1992;99:1351–1357.
86.British Multicentre Study Group. Photocoagulation for proliferative diabetic retinopathy: a randomised controlled clinical trial using the xenon-arc. Diabetologia. 1984;26:109–115.
87.British Multicentre Study Group. Photocoagulation for diabetic maculopathy. A randomized controlled clinical trial using the xenon arc. Diabetes. 1983;32: 1010–1016.
88.Hercules BL, Gayed II, Lucas SB, Jeacock J. Peripheral retinal ablation in the treatment of proliferative diabetic retinopathy: a three-year interim report of a randomised, controlled study using the argon laser. Br J Ophthalmol. 1977;61:555–563.
89.Patz A, Schatz H, Berkow JW, Gittelsohn AM, Ticho U. Macular edema--an overlooked complication of diabetic retinopathy. Trans Am Acad Ophthalmol Otolaryngol. 1973;77:OP34–OP42.
90.Lövestam-Adrian M, Agardh CD, Torffvit O, Agardh E. Type 1 diabetes patients with severe non-proliferative retinopathy may benefit from panretinal photocoagulation. Acta Ophthalmol Scand. 2003;81:221–225.
91.Early Treatment Diabetic Retinopathy Study research group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Arch Ophthalmol. 1985;103:1796–1806.
92.Diabetic Retinopathy Clinical Research Network. Comparison of the modified Early Treatment Diabetic Retinopathy Study and mild macular grid laser photocoagulation strategies for diabetic macular edema. Arch Ophthalmol. 2007;125:469–480.
93.Blankenship GW. Diabetic macular edema and argon laser photocoagulation: a prospective randomized study. Ophthalmology. 1979;86:69–78.
94.Olk RJ. Modified grid argon (blue-green) laser photocoagulation for diffuse diabetic macular edema. Ophthalmology. 1986;93:938–950.
95.Photocoagulation in treatment of diabetic maculopathy. Interim report of a multicentre controlled study. Lancet. 1975;2:1110–1113.
96.Ladas ID, Theodossiadis GP. Long-term effectiveness of modified grid laser photocoagulation for diffuse diabetic macular edema. Acta Ophthalmol (Copenh). 1993;71:393–397.
97.Pahor D. Visual field loss after argon laser panretinal photocoagulation in diabetic retinopathy: fullversus mild-scatter coagulation. Int Ophthalmol. 1998;22:313–319.
98.Buckley SA, Jenkins L, Benjamin L. Fields, DVLC and panretinal photocoagulation. Eye. 1992;6(Pt 6):623–625.
99.Fong DS, Girach A, Boney A. Visual side effects of successful scatter laser photocoagulation surgery for proliferative diabetic retinopathy: a literature review. Retina. 2007;27:816–824.
100.Early Treatment Diabetic Retinopathy Study Research Group. Focal photocoagulation treatment of diabetic macular edema. Relationship of treatment effect to fluorescein angiographic and other retinal characteristics at baseline: ETDRS report no. 19. Arch Ophthalmol. 1995;113:1144–1155.
298 Diabetes and Ocular Disease
101.Ho T, Smiddy WE, Flynn HW Jr. Vitrectomy in the management of diabetic eye disease. Surv Ophthalmol. 1992;37:190–202.
102.The Diabetic Retinopathy Vitrectomy Study Research Group. Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy. Two-year results of a randomized trial. Diabetic Retinopathy Vitrectomy Study report 2. Arch Ophthalmol. 1985;103:1644–1652.
103.The Diabetic Retinopathy Vitrectomy Study Research Group. Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Results of a randomized trial—Diabetic Retinopathy Vitrectomy Study Report 3. Ophthalmology. 1988;95:1307–1320.
104.The Diabetic Retinopathy Vitrectomy Study Research Group. Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Clinical application of results of a randomized trial—Diabetic Retinopathy Vitrectomy Study Report 4. Ophthalmology. 1988;95:1321–1334.
105.Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy. Four-year results of a randomized trial: Diabetic Retinopathy Vitrectomy Study Report 5. Arch Ophthalmol. 1990;108:958–964.
106.Gillies MC, Sutter FK, Simpson JM, Larsson J, Ali H, Zhu M. Intravitreal triamcinolone for refractory diabetic macular edema: two-year results of a doublemasked, placebo-controlled, randomized clinical trial. Ophthalmology. 2006;113: 1533–1538.
107.Pearson, Levy, Comstock, Fluocinolone Acetonide Implant study group. Fluocinolone acetonide intravitreal implant to treat diabetic macular edema: 3-year results of a multi-center clinical trial. Invest Ophthalmol Vis Sci. 2006;E-Abstract 5442.
108.Yanyali A, Horozoglu F, Celik E, Ercalik Y, Nohutcu AF. Pars plana vitrectomy and removal of the internal limiting membrane in diabetic macular edema unresponsive to grid laser photocoagulation. Eur J Ophthalmol. 2006;16:573–581.
109.Thomas D, Bunce C, Moorman C, Laidlaw DA. A randomised controlled feasibility trial of vitrectomy versus laser for diabetic macular oedema. Br J Ophthalmol. 2005;89:81–86.
110.Dhingra N, Sahni J, Shipley J, et al. Vitrectomy and Internal Limiting Membrane (ILM) removal for diabetic macular edema in eyes with absent vitreo-macular traction fails to improve visual acuity: results of a 12 months prospective randomized controlled clinical trial. Invest Ophthalmol Vis Sci. 2005;46:1467.
111.Bahadir M, Ertan A, Mertog˘lu O. Visual acuity comparison of vitrectomy with and without internal limiting membrane removal in the treatment of diabetic macular edema. Int Ophthalmol. 2005;26:3–8.
112.Smiddy WE, Flynn HW. Vitrectomy in the management of diabetic retinopathy. Surv Ophthalmol. 1999;43:491–507.
113.Early Treatment Diabetic Retinopathy Study Research Group. Treatment techniques and clinical guidelines for photocoagulation of diabetic macular edema. Early Treatment Diabetic Retinopathy Study Report Number 2. Ophthalmology. 1987;94: 761–774.
114.Akduman L, Olk RJ. Diode laser (810 nm) versus argon green (514 nm) modified grid photocoagulation for diffuse diabetic macular edema. Ophthalmology. 1997;104:1433–1441.
115.Canning C, Polkinghorne P, Ariffin A, Gregor Z. Panretinal laser photocoagulation for proliferative diabetic retinopathy: the effect of laser wavelength on macular function. Br J Ophthalmol. 1991;75:608–610.
Management of Diabetic Retinopathy |
299 |
116.Akduman L, Olk RJ. Subthreshold (invisible) modified grid diode laser photocoagulation in diffuse diabetic macular edema (DDME) Ophthalmic Surg Lasers. 1999;30:706–714.
117.La Heij EC, Hendrikse F, Kessels AG, Derhaag PJ. Vitrectomy results in diabetic macular oedema without evident vitreomacular traction. Graefes Arch Clin Exp Ophthalmol. 2001;239:264–270.
118.Dillinger P, Mester U. Vitrectomy with removal of the internal limiting membrane in chronic diabetic macular oedema. Graefes Arch Clin Exp Ophthalmol. 2004;242:630–637.
119.Yang CM. Surgical treatment for severe diabetic macular edema with massive hard exudates. Retina. 2000;20:121–125.
120.Kralinger MT, Pedri M, Kralinger F, Troger J, Kieselbach GF. Long-term outcome after vitrectomy for diabetic macular edema. Ophthalmologica. 2006;220:147–152.
121.Stolba U, Binder S, Gruber D, Krebs I, Aggermann T, Neumaier B. Vitrectomy for persistent diffuse diabetic macular edema. Am J Ophthalmol. 2005;140:295–301.
122.Yanyali A, Nohutcu AF, Horozoglu F, Celik E. Modified grid laser photocoagulation versus pars plana vitrectomy with internal limiting membrane removal in diabetic macular edema. Am J Ophthalmol. 2005;139:795–801.
123.Sobrin L, D’Amico DJ. Controversies in intravitreal triamcinolone acetonide use. Int Ophthalmol Clin. 2005;45:133–141.
124.Jonas JB, Söfker A. Intraocular injection of crystalline cortisone as adjunctive treatment of diabetic macular edema. Am J Ophthalmol. 2001;132:425–427.
125.Jonas JB, Kreissig I, Söfker A, Degenring RF. Intravitreal injection of triamcinolone for diffuse diabetic macular edema. Arch Ophthalmol. 2003;121:57–61.
126.Martidis A, Duker JS, Greenberg PB, et al. Intravitreal triamcinolone for refractory diabetic macular edema. Ophthalmology. 2002;109:920–927.
127.Avitabile T, Longo A, Reibaldi A. Intravitreal triamcinolone compared with macular laser grid photocoagulation for the treatment of cystoid macular edema. Am J Ophthalmol. 2005;140:695–702.
128.Kang SW, Sa HS, Cho HY, Kim JI. Macular grid photocoagulation after intravitreal triamcinolone acetonide for diffuse diabetic macular edema. Arch Ophthalmol. 2006;124:653–658.
129.Jonas JB, Kamppeter BA, Harder B, Vossmerbaeumer U, Sauder G, Spandau UH. Intravitreal triamcinolone acetonide for diabetic macular edema: a prospective, randomized study. J Ocul Pharmacol Ther. 2006;22:200–207.
130.Massin P, Audren F, Haouchine B, et al. Intravitreal triamcinolone acetonide for diabetic diffuse macular edema: preliminary results of a prospective controlled trial. Ophthalmology. 2004;111:218–224; discussion 224–225.
131.Audren F, Erginay A, Haouchine B, et al. Intravitreal triamcinolone acetonide for diffuse diabetic macular oedema: 6-month results of a prospective controlled trial.
Acta Ophthalmol Scand. 2006;84:624–630.
132.Audren F, Lecleire-Collet A, Erginay A, et al. Intravitreal triamcinolone acetonide for diffuse diabetic macular edema: phase 2 trial comparing 4 mg vs 2 mg. Am J Ophthalmol. 2006;142:794–799.
133.Jonas JB, Kreissig I, Spandau UH, Harder B. Infectious and noninfectious endophthalmitis after intravitreal high-dosage triamcinolone acetonide. Am J Ophthalmol. 2006;141:579–580.
134.Jonas JB, Degenring RF, Kreissig I, Akkoyun I, Kamppeter BA. Intraocular pressure elevation after intravitreal triamcinolone acetonide injection. Ophthalmology. 2005;112:593–598.
300 Diabetes and Ocular Disease
135.Gillies MC, Simpson JM, Billson FA, et al. Safety of an intravitreal injection of triamcinolone: results from a randomized clinical trial. Arch Ophthalmol. 2004;122:336–340.
136.Westfall AC, Osborn A, Kuhl D, Benz MS, Mieler WF, Holz ER. Acute endophthalmitis incidence: intravitreal triamcinolone. Arch Ophthalmol. 2005;123:1075–1077.
137.Available at; http://www.nei.nih.gov/neitrials/viewStudyWeb.aspx?id=105. (Accessed May 2006.)
138.Spandau UH, Derse M, Schmitz-Valckenber P, Papoulis C, Jonas JB. Dosage dependency of intravitreal triamcinolone acetonide as treatment for diabetic macular oedema. Br J Ophthalmol. 2005; 89:8, 999–1003.
139.Diabetic Retinopathy Clinical Research Network, Chew E, Strauber S, et al. Randomized trial of peribulbar triamcinolone acetonide with and without focal photocoagulation for mild diabetic macular edema: a pilot study. Ophthalmology. 2007;114:1190–1196.
140.Kuppermann BD, Blumenkranz MS, Haller JA, Williams GA, Posurdex Study Group. An intravitreous dexamethasone bioerodible drug delivery system for the treatment of persistent diabetic macular edema. Invest Ophthalmol Vis Sci. 2003;44:E-Abstract 4289.
141.Cunningham ET, Adamis AP, Altaweel M, et al. A phase II randomized doublemasked trial of pegaptanib, an anti-vascular endothelial growth factor aptamer, for diabetic macular edema. Ophthalmology. 2005;112:1747–1757.
142.Adamis AP, Altaweel M, Bressler NM, et al. Changes in retinal neovascularization after pegaptanib (Macugen) therapy in diabetic individuals. Ophthalmology. 2006;113:23–28.
143.Brown DM, Kaiser PK, Michels M, et al. Ranibizumab versus verteporfin for neovascular age-related macular degeneration. N Engl J Med. 2006;355:1432–1444.
144.Rosenfeld PJ, Brown DM, Heier JS, et al. Ranibizumab for neovascular age-related macular degeneration. N Engl J Med. 2006;355:1419–1431.
145.Chun DW, Heier JS, Topping TM, Duker JS, Bankert JM. A pilot study of multiple intravitreal injections of ranibizumab in patients with center-involving clinically significant diabetic macular edema. Ophthalmology. 2006;113:1706–1712.
146.Avery RL. Regression of retinal and iris neovascularization after intravitreal bevacizumab (Avastin) treatment. Retina. 2006;26:352–354.
147.Avery RL, Pearlman J, Pieramici DJ, et al. Intravitreal bevacizumab (Avastin) in the treatment of proliferative diabetic retinopathy. Ophthalmology. 2006;113:1695. e1–1695.e15.
148.Spaide RF, Fisher YL. Intravitreal bevacizumab (Avastin) treatment of proliferative diabetic retinopathy complicated by vitreous hemorrhage. Retina. 2006;26:275–278.
149.Rosenfeld, PJ. Intravitreal avastin: the low cost alternative to Lucentis? Am J Ophthalmol. 2006;142(1):141–143.
150.Gillies MC. What we don’t know about avastin might hurt us. Arch Ophthalmol. October 2006;124(10):1478–1479.
151.Diabetic Retinopathy Clinical Research Network. A phase II randomized clinical trial of intravitreal bevacizumab for diabetic macular edema. Ophthalmology. 2007;114:1860–1867.
152.Available at http://www.nei.nih.gov/neitrials/viewStudyWeb.aspx?id=129 (last accessed date February 23, 2009).
153.Available at http://www.clinicaltrials.gov/ct/show/NCT00347698?order=12 (last accessed date February 23, 2009).
15
Cataract Management in Diabetes
MITCHELL S. FINEMAN, MD,
WILLIAM E. BENSON, MD,
AND INGRID U. SCOTT, MD, MPH
CORE MESSAGES
•Patients with diabetes develop cataracts more frequently and at a younger age than patients without diabetes.
•Patients with diabetes are at increased risk of pseudophakic cystoid macular edema.
•Cataract surgery may be associated with postoperative progression of diabetic retinopathy.
Individuals who have diabetes mellitus not only develop cataracts more frequently than nondiabetic patients but also do so at a younger age [1–6]. They account for about 10% of people with visually significant cataracts and represent about 6% of the population of the United States [7–10]. Cataract is a frequent cause of visual loss in older-onset diabetic patients and is second only to proliferative diabetic retinopathy (PDR) in younger-onset diabetic patients [11]. Although the main indication for cataract surgery in diabetic patients is visual rehabilitation, it is occasionally required when the lens opacity prevents adequate
diagnosis or treatment of retinopathy [12].
Diabetic patients have a higher risk of both anterior and posterior segment complications following cataract surgery [13]. One of the most significant anterior segment complications is neovascularization of the iris (NVI), because it usually progresses to neovascular glaucoma [14–18]. Other anterior segment complications include pigment dispersion with precipitates on the surface of the intraocular lens (IOL), fibrinous exudate or membrane in the anterior chamber, and posterior synechiae (Fig. 15.1) [19–21]. The incidence of pseudophakic pupillary block with secondary angle-closure glaucoma [22] and postoperative posterior capsular
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A
B
Figure 15.1. (A) Posterior synechiae in an eye of a diabetic patient following extracapsular cataract extraction. (B) Resulting small size of pupil caused poor view of fundus and difficulties with peripheral laser photocoagulation.
opacification (Fig. 15.2) [23,24] is also reported to be greater in diabetic patients. Following cataract surgery in diabetic patients, macular edema, macular ischemia [25–32], PDR [28,33], vitreous hemorrhage [14,33], and tractional retinal detachment [33] may develop or worsen.
Figure 15.2. Slit-lamp photograph of an eye of a diabetic patient demonstrating severe posterior capsular opacification 2 months following cataract extraction. Posterior synechia is visible between the 4- and 5-o’clock positions.
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The best predictor of visual and anatomic outcomes after cataract surgery is the preoperative severity of retinopathy [14,27,28]. Other factors affecting the postoperative visual outcome are the age and gender of the patient [34], insulin treatment [32,35], glycemic control [35,36], prior laser photocoagulation [37], and previous vitrectomy [38].
In this chapter, unless otherwise specified, the term cataract surgery means phacoemulsification or extracapsular cataract extraction (ECCE) with placement of a posterior chamber IOL, because these techniques are currently used in nearly all cataract operations performed in the United States.
PREOPERATIVE SEVERITY OF RETINOPATHY
No or Mild Retinopathy. The current results of cataract surgery in diabetic patients with no or minimal retinopathy are comparable to those in nondiabetic persons [28,39–42]. About 85% of eyes can be expected to achieve a postoperative visual acuity of 20/40 or better [43]. However, the risk of angiographic pseudophakic cystoid macular edema (CME) is considerably higher than that in nondiabetic patients, and progression of retinopathy occurs in 15% of eyes within 18 months postoperatively [28].
Nonproliferative Retinopathy. Cataract surgery is often followed by progression of established nonproliferative diabetic retinopathy (NPDR) or by NVI (Fig. 15.3) [27–29,31,32,34,35,41]. In one study, clinically significant macular edema (CSME) developed postoperatively in 50% of eyes that did not have it preoperatively [34]. In some cases, progression of NPDR and CSME caused the postoperative visual acuity to be worse than the preoperative level (Fig. 15.4) [25,27]. Dowler and associates [43] performed a meta-analysis and calculated that 80% of eyes with preoperative NPDR and no macular edema achieve a visual acuity of 20/40 or better following ECCE.
In the Early Treatment Diabetic Retinopathy Study (ETDRS), evaluation of 1-year postoperative visual acuities for all eyes with mild-to-moderate NPDR at the annual visit prior to cataract surgery showed that 53% achieved better than 20/40, 90% better than 20/100, and 10% achieved 5/200 or worse [44]. Severity of retinopathy at the time of lens removal is the most important predictor of poor visual acuity outcome in the study by Dowler and associates [43] and in the ETDRS Report Number 25 [44].
Several investigators have reported that cataract surgery does not lead to progression of preexisting retinopathy [39,45]. Romero-Aroca and associates studied 132 diabetic patients with NPDR who underwent phacoemulsification in one eye; with a mean follow-up interval of 11 months, there was no difference between the operated and fellow eyes in the proportion of eyes with diabetic retinopathy progression [46]. Other investigators have also reported that phacoemulsification with IOL implantation is not associated with diabetic retinopathy progression and that visual improvement is achieved in the majority of patients with NPDR without macular edema; a poorer visual outcome is observed in patients who develop