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Gestion médicochirurgicale de l’hémorragie intravitréenne chez le patient diabétique.

Auteurs : Bouazza M1, Razzak A1, Amri G1, Zadnass M2, Rayad R2, Oubaaz A1
Affiliations : 1Service d'ophtalmologie, Faculty of Medicine, Mohammed VI University of Health Sciences (UM6SS), Cheikh-Khalifa International University Hospital, Casablanca, Maroc.2Service d'ophtalmologie, Hassan II University, hôpital 20 Août 1953, Casablanca, Maroc.
Date 2023 Août 17Revue : Journal français d'ophtalmologieType de publication : résumé en anglais; article de périodique; DOI : 10.1016/j.jfo.2023.02.022
Résumé

Vitreous hemorrhage (VH) is the main complication of proliferative diabetic retinopathy and remains the primary indication for vitrectomy in diabetic patients. The objective of our study is to compare our medical and surgical management of VH with data from the literature and to report the functional results of our series. We studied a series of 284 cases collected over 2 years in two tertiary care centers. In our series, 90.1% of patients had type 2 diabetes, and 70% had glycosylated hemoglobin greater than 7.5%. On fundus examination, 35.2% presented with stage 1 VH, 42.6% with stage 2, 3.6% with stage 3 and 5.2% with stage 4. Ocular ultrasound performed when fundus exam was difficult diagnosed an associated tractional retinal detachment in 8.8% of patients. Medical treatment was sufficient in 77.8% of patients, while 22.2% of our patients underwent vitrectomy, argon laser endophotocoagulation and postoperative anti-VEGF injection. Peeling of tractional fibrovascular membranes and or associated epiretinal membranes was performed in 69.8% of cases. Iatrogenic tears were noted in 11.8% of patients. In this study, 31.5% of patients underwent intraocular gas tamponade, while 23.8% of cases underwent silicone oil tamponade. Postoperative visual acuity improved by at least 2 lines in 60% of our patients, and the VH recurred in 24.2% of cases after surgery.

Mot-clés auteurs
anti-vegf; argon laser; diabetic retinopathy; hémorragie intravitréenne; laser argon; prevention; prévention; rétinopathie diabétique; vitrectomie; vitrectomy; vitreous hemorrhage;

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 Source : MEDLINE©/Pubmed© U.S National Library of Medicine
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Bouazza M, Razzak A, Amri G, Zadnass M, Rayad R, Oubaaz A. Gestion médicochirurgicale de l’hémorragie intravitréenne chez le patient diabétique. Journal français d'ophtalmologie. 2023 Août 17.
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Dernière date de mise à jour : 25/08/2023.


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