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Retinal changes after silicone oil and C3F8 gas filling in patients with proliferative diabetic retinopathy

Posting time:2022-12-02 07:18:27

Retinal changes after silicone oil and C3F8 gas filling in patients with proliferative diabetic retinopathy

In June 2022, the team of Prof. Hanyi Min from Peking Union Medical College Hospital published a research paper entitled "Comparison of Retinal Changes Following Silicone Oil and Perfluoropropane Gas Tamponade for Proliferative Diabetic Retinopathy Patients" in the journal Frontiers in Physiology (JCR 1, IF=4.755). . This study used a prospective cohort study method to observe retinal structure and blood flow in patients with proliferative retinopathy (PDR) after vitrectomy (PPV) using optical coherence tomography and blood flow imaging (OCT/OCTA). Longitudinal changes to compare the effects of vitreous cavity filling with silicone oil (SO) and C3F8 gas (Gas) on the retina of PDR patients. Diabetic retinopathy (DR) is a common cause of vision loss worldwide. During the pathogenesis of DR, retinal microvessels are progressively damaged, followed by retinal exudation, hemorrhage, or the protrusion of arterioles from their walls to form microaneurysms, which eventually evolve into PDR. In PDR, the formation of neovascularization and fibrosis will eventually lead to traction retinal detachment (TRD) and blindness. PPV is an important treatment for vitreous hemorrhage (VH) and TRD in patients with PDR. However, the difficulty and risk of PPV is greatly increased when vitreoretinal adhesions are present in PDR patients. According to previous studies, SO or Gas filling of the vitreous cavity combined with PPV surgery can significantly improve the therapeutic effect. Although SO and Gas fillers are currently widely used in PPV surgery for PDR, few studies have compared the effects of two different filler materials on the retina of PDR patients. The purpose of this study was to measure the longitudinal changes of retinal structure and blood flow in PDR patients after PPV surgery by OCT/OCTA technique, and to compare the differences in the effects of SO and Gas filling on the retina of PDR patients. This study prospectively enrolled 38 patients (47 eyes) with PDR who met the criteria and underwent PPV surgery. According to the different fillers in PPV surgery, the included patients were divided into two groups (Figure 1): SO group (silicone oil) and Gas group (C3F8 gas). The primary outcome measure was longitudinal changes in retinal structure and blood vessels between 10 and 90 days after surgery. Secondary outcome measures were longitudinal changes in peripaptic nerve fiber layer (pRNFL) thickness and blood flow from 10 to 90 days postoperatively. Figure 1. Study flow chart Finally, 27 patients (36 eyes) with PDR completed the follow-up program, with a mean age of 56.6±9.8 years. There were no significant differences in demographic and clinical characteristics between the two groups of patients. The pRNFL thickness in the SO group decreased significantly from 10 days to 90 days after the operation (P Figure 2. Comparison of the changes in the pRNFL thickness between the two groups). Compared with C3F8 gas, pRNFL thickness decreased more in PDR patients within 90 days after SO filling during PPV, and changes in pRNFL thickness were significantly associated with changes in panretinal thickness and superficial retinal blood flow density. Therefore, ophthalmologists should Pay attention to the decrease in pRNF thickness after SO filling of the vitreous cavity in PDR patients, so as to appropriately manage the structural changes of the retina during postoperative follow-up.【Author Information】First author Tan Wang, MD, MD, 2021, Peking Union Medical College Hospital, Under the tutelage of Professor Min Hanyi. The main research direction is fundus diseases and imaging medicine. In the past three years, he has published 2 papers in SCI journals, 1 conference abstract, and 3 papers in core journals of Peking University. Wang Erqian, MD, graduated in 2012 Attending physician at Peking Union Medical College, Peking Union Medical College Hospital. Main research directions: choroidal hypertrophy spectrum diseases, choroidal neovascular membrane secondary to pathological myopia, OCT and OCTA image analysis. In the past five years, he has published more than ten papers at home and abroad, Published 2 papers in RETINA as the first author. Participated in the National Natural Science Foundation of China and participated in a number of clinical trials. Corresponding author Min Hanyi, MD, chief physician, professor, doctoral tutor. Graduated from Sun Yat-Sen Medical University in 1995 Department of Clinical Medicine, successively obtained master and doctorate degrees from Chinese Academy of Medical Sciences and Union Medical University. He is good at various types of cataract surgery; Member of the blindness prevention group of the branch, member of the evidence-based group of the Ophthalmology Branch of the Chinese Medical Association, director-general of the Ophthalmology Branch of the Beijing Medical Association, member of the fifth council of the Beijing Medical Association, member of the Vision Restoration Committee of the CMDA Neurorestoration Professional Committee, Zhonghua Member of the Fourth Medical Appraisal Expert Bank of the Medical Association, member of the National Health Emergency Response Guidance Expert Bank, and member of the 2021 Experimental Animal Welfare Ethics Committee of Peking Union Medical College Hospital. Published more than 20 domestic papers and more than 20 SCI papers. Editor-in-chief of 3 monographs, respectively It is "Diagnostic Atlas of Common Eye Diseases" published by People's Health Publishing House in 2011, "Stereo Atlas of vitreoretinal diseases" published by People's Health Publishing House in 2016; editor-in-chief of "Stereo Atlas of vitreoretinal diseases" published by Springer in 2020. Text / edited by Wang Tan Minhanyi / Rotating Editor-in-Chief of Cao Miao / Editor-in-Chief Chen Di / Producer Zhao Chan / Chen Youxin

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