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2015 ; 2015
(ä): 392983
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The Vitreomacular Interface in Diabetic Retinopathy
#MMPMID26425349
Agarwal D
; Gelman R
; Prospero Ponce C
; Stevenson W
; Christoforidis JB
J Ophthalmol
2015[]; 2015
(ä): 392983
PMID26425349
show ga
Diabetic retinopathy (DR) is a leading health concern and a major cause of
blindness. DR can be complicated by scar tissue formation, macular edema, and
tractional retinal detachment. Optical coherence tomography has found that
patients with DR often have diffuse retinal thickening, cystoid macular edema,
posterior hyaloid traction, and tractional retinal detachment. Newer imaging
techniques can even detect fine tangential folds and serous macular detachment.
The interplay of the vitreous and the retina in the progression of DR involves
multiple chemokine and other regulatory factors including VEGF. Understanding the
cells infiltrating pathologic membranes at the vitreomacular interface has opened
up the possibility of new targets for pharmacotherapy. Vitrectomies for DR remain
a vital tool to help relieve tension on the macula by removing membranes,
improving edema absorption, and eliminating the scaffold for new membrane
formation. Newer treatments such as triamcinolone acetonide and VEGF inhibitors
have become essential as a rapid way to control DR at the vitreomacular
interface, improve macular edema, and reduce retinal neovascularization. These
treatments alone, and in conjunction with PRP, help to prevent worsening of the
VMI in patients with DR.