증식당뇨망막병증 유리체절제술 후 발생한 신생혈관녹내장과 아메드밸브 삽입술 = Neovascular Glaucoma after Vitrectomy for Proliferative Diabetic Retinopathy and the Ahmed Valve Implantation

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the clinical features of neovascular glaucoma after vitrectomy for proliferative diabetic retinopathy and the effect of Ahmed valve implantation. Methods: The medical records of 217 eyes of 178 patients who had undergone pars plana vitrectomy for proliferative diabetic retinopathy were reviewed. The clinical data on preoperative, intraoperative, and postoperative factors of these patients were compared with that of those who developed neovascular glaucoma (20 eyes of 18 patients) after vitrectomy. The effect and complications of Ahmed valve implantation were also reviewed. Results: The type 1 diabetes, the presence of NVD, grade of NVE, grade of preoperative PRP, presence of postoperative vitreous hemorrhage, and postoperative tractional retinal detachment were significantly correlated with the development of neovascular glaucoma. Ahmed valve implantation in these patients was effective in controlling intraocular pressure and improving visual acuity. Complications of the Ahmed valve implantation were hyphema, tube exposure, recurrent vitreous hemorrhage, hypotony, and choroidal effusion. Conclusions: The risk factors for the development of neovascular glaucoma after vitrectomy for proliferative diabetic retinopathy were evaluated. Ahmed valve implantation in these patients is considered an effective treatment for controlling intraocular pressure.

참고문헌 (Reference)

1 "Vitreous Levels of VEGF and Surgical Outcomes after Vitrectomy in Proliferative Diabetic Retinopathy" 45 : 1466-1477, 2004

2 "Vitrectomy for complication of diabetic traction retinal detachment" 88 : 237-46, 1978

3 "Vitrectomy combined with lensectomy for complications of proliferative diabetic retinopathy" 39 : 2406-2411, 1998

4 "Vascular endothelial growth factor level in aqueous humor of diabetic patients with rubeotic glaucoma is markedly elevated" 19 : 1306-1307, 1996

5 "Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders" 331 : 1480-7, 1994

6 "The effect of lensectomy on the incidence of iris neovascularization and neovascular glaucoma after vitrectomy for diabetic retinopathy" 95 : 1-11, 1983

7 "The Study of Intraocular Vascular Endothelial Growth Factor Concentration in Diabetic Retinopathy after Panretinal Photocoagulation" 40 : 3384-3389, 1999

8 "Serum factors associated with neovascular glaucoma following vitrectomy for proliferative diabetic retinopathy" 15 : 81-86, 2001

9 "Rubeosis iridis after vitrectomy for diabetic retinopathy" 236 : 730-733, 1998

10 "Retinal ischemia in diabetic retinopathy" 93 : 1300-10, 1975

11 "Retinal ischemia and angle neovascularization in proliferative diabetic retinopathy" 132 : 648-658, 2001

12 "Regulation of angiogenesis in diabetic retinopathy:possible balance between vascular endothelial growth factor and endostatin" 120 : 1075-1080, 2002

13 "Outcome of vitreous surgery and the balance between vascular endothelial growth factor and endostatin" 44 : 1042-1047, 2003

14 "Neovaseular Glaucoma after Vitrectomy for Proliferative Diabetic Retinopathy" 38 : 2028-2035, 1997

15 "Neovascularization of the iris in rhegmatogeneous retinal detachment" 112 : 632-4, 1991

16 "Neovascular glaucoma:current concepts" 78 : 330-3, 1974

17 "Neovascular glaucoma following pars plana vitrectomy for complication of diabetic retinopathy" 21 : 113-8, 1990

18 "Neovascular glaucoma following neodymium-YAG laser posterior capsulotomy" 730-1,

19 "Neovascular glaucoma and vitreous hemorrhage after cataract surgery in patients with diabetes mellitus" 90 : 814-20, 1983

20 "Management of the neovascular glaucomas" 29 : 603-10, 1988

21 "Late complication of pars plana vitreous surgery" 85 : 126-40, 1978

22 "Iris neovascularization after vitrectomy combined with phacoemulsification and intraocular lens implantation for proliferative diabetic retinopathy" 32 : 19-24, 2001

23 "Intermediate-term clinical experience with the Ahmed Glaucoma Valve implant" 127 : 27-33, 1999

24 "Increased level of vascular endothelial growth factor in aqueous humor of patients with neovascular glaucoma" 105 : 232-237, 1998

25 "Grading diabetic retinopathy from stereoscopic color fundus photographs-an extension of the modified Airlie House classification" 98 : 786-806, 1991

26 "Fundus photographic risk factors for progression of diabetic retinopathy" 98 : 823-33, 1991

27 "Filtration surgery in the treatment of neovascular glaucoma" 89 : 1181-7, 1982

28 "Evidence-based recommendations for the diagnosis and treatment of neovascular glaucoma" 108 : 1767-1776, 2001

29 "Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy" 108 : 958-64, 1990

30 "Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision" 95 : 1307-34, 1988

31 "Different determinants of neovascularization on the optic disc and on the retina in patients with severe nonproliferative diabetic retinopathy" 111 : 203-6, 1993

32 "Cyclocryotherapy in neovascular glaucoma" 86 : 24-6, 1978

33 "Complications of vitreous surgery from diabetic retinopathy II" 90 : 517-21, 1983

34 "Comparison between efficacy of full- and mild-scatter(panretinal)photocoagulation on the course of diabetic rubeosis iridis" 207 : 144-7, 1993

35 "Combined Pars Plana Vitrectomy and Ahmed Implantation for Refractory Glaucoma" 37 : 1893-1901, 1996

36 "Clinical Results of Ahmed Valve Implantation in the Aspects of Complications" 44 : 888-895, 2003

37 "Ahmed Glaucoma Valve Implant in Refractory Glaucoma" 38 : 259-266, 1997

38 "Ahmed Glaucoma Valve Implant for Neovascular Glaucoma" 40 : 1950-1959, 1999