Receieved: 17.02.2022; Accepted: 06.06.2022; Published on-line 15.06.2022
Managing proliferative diabetic retinopathy in a patient with vitreous hemorrhage: a case report
O. B. Koshchynets, R. L. Vadiuk
Ivano-Frankivsk National Medical University; Ivano-Frankivsk (Ukraine)
Koshchynets OB, Vadiuk RL. Managing proliferative diabetic retinopathy in a patient with vitreous hemorrhage: a case report. http://doi.org/10.31288/oftalmolzh202235457
We report a case of successful treatment of a 35-year-old patient diagnosed with severe type 1 diabetes mellitus with moderate glycemic control, bilateral proliferative diabetic retinopathy and total vitreous hemorrhage in the right eye. At baseline, there was optical coherence tomography angiography and fundus photography evidence of significant neovascularization of the optic nerve and peripapillary retina along the vessels. Although Ukrainian guidelines on the use of aflibercept do not mention retinal neovascularization in diabetic retinopathy in the absence of diabetic macular edema as an indication for the use of aflibercept, we relied on the experience of foreign colleagues and the eye without hemorrhage was treated with five monthly loading injections of intreavitreal aflibercept 0.05 ml, and, after the first year, treatment was continued according to a “treat and extend” strategy. The case reported demonstrated that intravitreal aflibercept in combination with panretinal laser photocoagulation is effective for regression of neovascularization and prevention of recurrent vitreous hemorrhage.
Keywords: proliferative diabetic retinopathy, neovascularization, intravitreal injection, ant-VEGF agents
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Corresponding Author: Koshchynets Olesia, email: firstname.lastname@example.org
Author contribution: Vadiuk R.L.: conservative and surgical treatment of the patient, concept and editing; Vadiuk R.L., Koshchynets O.B.: the idea of publishing and editing the article; Koshchynets O.B.: literature analysis and article formation.
Conflict of Interest: The authors state that there is no conflict of interest that could affect their opinion on the topic or material presented in the manuscript.
Abbreviations: DM – diabetes mellitus; DR– diabetic retinopathy; PDR – proliferative diabetic retinopathy; VEGF – vascular endothelial growth factor; NVE – new vessels elsewhere; NVD – new vessels on the disc; DME – diabetic macular edema; IOP - intraocular pressure, ОСТА – optical coherence tomography angiography.