title: Combined Tractional and Rhegmatogenous Retinal Detachment in Proliferative Diabetic Retinopathy in the Anti-VEGF Era.
abstract: Purpose. To investigate the clinical features, surgical outcomes, and prognostic factors of combined rhegmatogenous and tractional detachment (combined RD) in proliferative diabetic retinopathy (PDR) in recent years. Methods. Medical records of PDR and combined RD treated with vitrectomy from 2008 to 2013 were retrospectively reviewed. Results. A total of 57 eyes from 49 patients were included. Nine eyes had received panretinal photocoagulation (PRP) and 7 eyes had intravitreal bevacizumab (IVB) within 3 months before RD developed. Thirty-eight eyes (66.7%) had ≧3 sites of broad adhesion of fibrovascular proliferation (FVP). Thirty-three eyes (57.9%) showed active FVP. Thirty-four eyes (59.6%) had extent of RD involving 3 or 4 quadrants. The primary reattachment rate was 93.0%, and the final visual acuity (VA) improved by more than 3 lines in 80.7% of eyes. Neovascular glaucoma occurred in 4 eyes postoperatively. Poor preoperative VA, severe vitreoretinal adhesion, and broad extent of RD had significant correlation with poor visual outcomes. Conclusion. PRP or IVB might play a role in provoking combined RD. The anatomical and functional success rates of surgery were high. Poor preoperative VA and severe proliferations predicted poor visual outcomes.
authors: Department of Ophthalmology, National Taiwan University Hospital and Medical College, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 100, Taiwan.
authors: Ya-Jui
authors: 0000-0001-7804-5338
authors: YJ
authors: Hsu
authors: Department of Ophthalmology, National Taiwan University Hospital and Medical College, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 100, Taiwan.
authors: Yi-Ting
authors: YT
authors: Hsieh
authors: Department of Ophthalmology, National Taiwan University Hospital and Medical College, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 100, Taiwan.
authors: Po-Ting
authors: 0000-0002-0461-8778
authors: PT
authors: Yeh
authors: Department of Ophthalmology, National Taiwan University Hospital and Medical College, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 100, Taiwan.
authors: Jehn-Yu
authors: 0000-0002-4452-4557
authors: JY
authors: Huang
authors: Department of Ophthalmology, National Taiwan University Hospital and Medical College, National Taiwan University, No. 7, Chung-Shan South Road, Taipei 100, Taiwan.
authors: Chung-May
authors: CM
authors: Yang