Intravitreal Tissue Plasminogen Activator Injection for Treatment-Resistant Diabetic Macular Edema of the Vitrectomized Eye

Diabetic macular edema (DME) is the main cause of visual loss in patients with diabetic retinopathy. DME has been treated using intravitreal anti-vascular endothelial growth factor (VEGF) drugs, steroids, laser photocoagulation, vitreoretinal surgery, and their combinations. These modalities are gen...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Ren Aoki, Makoto Hatano, Fumiaki Higashijima, Takuya Yoshimoto, Masanori Mikuni, Tadahiko Ogata, Yuka Kobayashi, Makiko Wakuta, Kazuhiro Kimura
Formato:	article
Lenguaje:	EN
Publicado:	Karger Publishers 2021
Materias:	tissue plasminogen activator diabetic macular edema vitrectomized eye central retinal thickness visual acuity Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/a7bc3bcbc55f46a5a30e91fc8cfbb2e9
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:a7bc3bcbc55f46a5a30e91fc8cfbb2e9
record_format	dspace
spelling	oai:doaj.org-article:a7bc3bcbc55f46a5a30e91fc8cfbb2e92021-11-11T10:40:45ZIntravitreal Tissue Plasminogen Activator Injection for Treatment-Resistant Diabetic Macular Edema of the Vitrectomized Eye1663-269910.1159/000518289https://doaj.org/article/a7bc3bcbc55f46a5a30e91fc8cfbb2e92021-10-01T00:00:00Zhttps://www.karger.com/Article/FullText/518289https://doaj.org/toc/1663-2699Diabetic macular edema (DME) is the main cause of visual loss in patients with diabetic retinopathy. DME has been treated using intravitreal anti-vascular endothelial growth factor (VEGF) drugs, steroids, laser photocoagulation, vitreoretinal surgery, and their combinations. These modalities are generally effective in preserving vision, but they sometimes produce only limited responses in patients with persistent or refractory DME. The levels of various inflammatory factors, including cytokines, chemokines, and extracellular matrices, as well as VEGF in the vitreous fluid, are increased in patients with DME. Excessive fibrinogen/fibrin levels in the vitreous fluid or fibrin deposition in the retina also contribute to DME pathogenesis. Tissue plasminogen activator (t-PA) promotes the degradation of fibrinogen or fibrin. Intravitreal t-PA injection is a commonly used treatment for subretinal hemorrhage secondary to age-related macular degeneration. Intravitreal t-PA injections have previously been used to restore vision by inducing posterior vitreous detachment in patients with DME. Herein, we describe the visual outcomes of intravitreal t-PA injection in a 78-year-old woman with treatment-resistant DME in her vitrectomized eye after several previous treatments. Before the injection, her best-corrected visual acuity (BCVA) was 0.7 logMAR and central foveal retinal thickness (CRT) was 735 μm. At 1 month after the injection, her BCVA was 0.8 logMAR and CRT was 558 μm, and 3 months later, her BCVA was 0.8 logMAR and CRT was 207 μm. Her BCVA was sustained, and CRT showed gradual improvements. These findings suggested the effectiveness of intravitreal t-PA injections for DME in the vitrectomized eye.Ren AokiMakoto HatanoFumiaki HigashijimaTakuya YoshimotoMasanori MikuniTadahiko OgataYuka KobayashiMakiko WakutaKazuhiro KimuraKarger Publishersarticletissue plasminogen activatordiabetic macular edemavitrectomized eyecentral retinal thicknessvisual acuityOphthalmologyRE1-994ENCase Reports in Ophthalmology, Vol 12, Iss 3, Pp 841-847 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	tissue plasminogen activator diabetic macular edema vitrectomized eye central retinal thickness visual acuity Ophthalmology RE1-994
spellingShingle	tissue plasminogen activator diabetic macular edema vitrectomized eye central retinal thickness visual acuity Ophthalmology RE1-994 Ren Aoki Makoto Hatano Fumiaki Higashijima Takuya Yoshimoto Masanori Mikuni Tadahiko Ogata Yuka Kobayashi Makiko Wakuta Kazuhiro Kimura Intravitreal Tissue Plasminogen Activator Injection for Treatment-Resistant Diabetic Macular Edema of the Vitrectomized Eye
description	Diabetic macular edema (DME) is the main cause of visual loss in patients with diabetic retinopathy. DME has been treated using intravitreal anti-vascular endothelial growth factor (VEGF) drugs, steroids, laser photocoagulation, vitreoretinal surgery, and their combinations. These modalities are generally effective in preserving vision, but they sometimes produce only limited responses in patients with persistent or refractory DME. The levels of various inflammatory factors, including cytokines, chemokines, and extracellular matrices, as well as VEGF in the vitreous fluid, are increased in patients with DME. Excessive fibrinogen/fibrin levels in the vitreous fluid or fibrin deposition in the retina also contribute to DME pathogenesis. Tissue plasminogen activator (t-PA) promotes the degradation of fibrinogen or fibrin. Intravitreal t-PA injection is a commonly used treatment for subretinal hemorrhage secondary to age-related macular degeneration. Intravitreal t-PA injections have previously been used to restore vision by inducing posterior vitreous detachment in patients with DME. Herein, we describe the visual outcomes of intravitreal t-PA injection in a 78-year-old woman with treatment-resistant DME in her vitrectomized eye after several previous treatments. Before the injection, her best-corrected visual acuity (BCVA) was 0.7 logMAR and central foveal retinal thickness (CRT) was 735 μm. At 1 month after the injection, her BCVA was 0.8 logMAR and CRT was 558 μm, and 3 months later, her BCVA was 0.8 logMAR and CRT was 207 μm. Her BCVA was sustained, and CRT showed gradual improvements. These findings suggested the effectiveness of intravitreal t-PA injections for DME in the vitrectomized eye.
format	article
author	Ren Aoki Makoto Hatano Fumiaki Higashijima Takuya Yoshimoto Masanori Mikuni Tadahiko Ogata Yuka Kobayashi Makiko Wakuta Kazuhiro Kimura
author_facet	Ren Aoki Makoto Hatano Fumiaki Higashijima Takuya Yoshimoto Masanori Mikuni Tadahiko Ogata Yuka Kobayashi Makiko Wakuta Kazuhiro Kimura
author_sort	Ren Aoki
title	Intravitreal Tissue Plasminogen Activator Injection for Treatment-Resistant Diabetic Macular Edema of the Vitrectomized Eye
title_short	Intravitreal Tissue Plasminogen Activator Injection for Treatment-Resistant Diabetic Macular Edema of the Vitrectomized Eye
title_full	Intravitreal Tissue Plasminogen Activator Injection for Treatment-Resistant Diabetic Macular Edema of the Vitrectomized Eye
title_fullStr	Intravitreal Tissue Plasminogen Activator Injection for Treatment-Resistant Diabetic Macular Edema of the Vitrectomized Eye
title_full_unstemmed	Intravitreal Tissue Plasminogen Activator Injection for Treatment-Resistant Diabetic Macular Edema of the Vitrectomized Eye
title_sort	intravitreal tissue plasminogen activator injection for treatment-resistant diabetic macular edema of the vitrectomized eye
publisher	Karger Publishers
publishDate	2021
url	https://doaj.org/article/a7bc3bcbc55f46a5a30e91fc8cfbb2e9
work_keys_str_mv	AT renaoki intravitrealtissueplasminogenactivatorinjectionfortreatmentresistantdiabeticmacularedemaofthevitrectomizedeye AT makotohatano intravitrealtissueplasminogenactivatorinjectionfortreatmentresistantdiabeticmacularedemaofthevitrectomizedeye AT fumiakihigashijima intravitrealtissueplasminogenactivatorinjectionfortreatmentresistantdiabeticmacularedemaofthevitrectomizedeye AT takuyayoshimoto intravitrealtissueplasminogenactivatorinjectionfortreatmentresistantdiabeticmacularedemaofthevitrectomizedeye AT masanorimikuni intravitrealtissueplasminogenactivatorinjectionfortreatmentresistantdiabeticmacularedemaofthevitrectomizedeye AT tadahikoogata intravitrealtissueplasminogenactivatorinjectionfortreatmentresistantdiabeticmacularedemaofthevitrectomizedeye AT yukakobayashi intravitrealtissueplasminogenactivatorinjectionfortreatmentresistantdiabeticmacularedemaofthevitrectomizedeye AT makikowakuta intravitrealtissueplasminogenactivatorinjectionfortreatmentresistantdiabeticmacularedemaofthevitrectomizedeye AT kazuhirokimura intravitrealtissueplasminogenactivatorinjectionfortreatmentresistantdiabeticmacularedemaofthevitrectomizedeye
_version_	1718439155311050752

Intravitreal Tissue Plasminogen Activator Injection for Treatment-Resistant Diabetic Macular Edema of the Vitrectomized Eye

Ejemplares similares