Comparison of Retinal Changes Following Silicone Oil and Perfluoropropane Gas Tamponade for Proliferative Diabetic Retinopathy Patients

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Abstract

Purpose: To investigate the different tamponade effects of intravitreal silicone oil (SO) and perfluoropropane gas on the retinal structure and vasculature in proliferative diabetic retinopathy (PDR) patients.

Methods: Thirty-eight eligible patients (47 eyes) with PDR requiring pars plana vitrectomy (PPV) were enrolled in the prospective observational study. Subjects were divided into two groups after PPV: SO group subjects underwent SO tamponade, whereas Gas group subjects underwent perfluoropropane gas tamponade. The primary outcomes of this study were longitudinal changes in retinal structure and vasculature between 10 and 90 days after the operation. Secondary outcomes were longitudinal changes in peripapillary retinal nerve fiber layer (pRNFL) thickness between 10 and 90 days after the operation in each sector.

Results: Thirty-six eyes of 27 patients with a median age of 56.6 ± 9.8 years completed follow-up and were statistically analyzed. No significant difference in demographics or clinical characteristics was found between the two groups. Eyes in the SO group had a statistically significant decrease in pRNFL thickness at 90 days after PPV ( p < 0.001), and there was a significant intergroup difference compared with the Gas group (p = 0.001), except for the temporal sector. Eyes in the Gas group had a statistically significant increase in parafoveal vessel density (VD) of the superficial vascular complex (SVC) at 90 days after PPV ( p = 0.023), although there was no significant intergroup difference. The type of tamponade, changes in full retina thickness, and parafoveal SVC VD showed a significant correlation with changes in pRNFL thickness (all p < 0.05).

Conclusion: SO tamponade resulted in a significantly greater decrease in pRNFL over 90 days than gas tamponade in patients with PDR. In addition, the change in the pRNFL was significantly correlated with changes in full retina thickness and SVC VD after the operation.

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Optical coherence tomography angiography

Richard Spaide, James Fujimoto, Nadia K. Waheed … (2017)

Optical coherence tomography (OCT) was one of the biggest advances in ophthalmic imaging. Building on that platform, OCT angiography (OCTA) provides depth resolved images of blood flow in the retina and choroid with levels of detail far exceeding that obtained with older forms of imaging. This new modality is challenging because of the need for new equipment and processing techniques, current limitations of imaging capability, and rapid advancements in both imaging and in our understanding of the imaging and applicable pathophysiology of the retina and choroid. These factors lead to a steep learning curve, even for those with a working understanding dye-based ocular angiography. All for a method of imaging that is a little more than 10 years old. This review begins with a historical account of the development of OCTA, and the methods used in OCTA, including signal processing, image generation, and display techniques. This forms the basis to understand what OCTA images show as well as how image artifacts arise. The anatomy and imaging of specific vascular layers of the eye are reviewed. The integration of OCTA in multimodal imaging in the evaluation of retinal vascular occlusive diseases, diabetic retinopathy, uveitis, inherited diseases, age-related macular degeneration, and disorders of the optic nerve is presented. OCTA is an exciting, disruptive technology. Its use is rapidly expanding in clinical practice as well as for research into the pathophysiology of diseases of the posterior pole.

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The 14-year incidence of visual loss in a diabetic population.

Marina Klein, S Moss, John Klein (1998)

The purpose of the study was to estimate the 14-year incidence of visual loss in a diabetic population and to examine its relationship to potential risk factors. Cohort study. A population-based sample of younger onset diabetic persons diagnosed younger than 30 years of age and taking insulin (n = 880) were examined at baseline, 4 years, 10 years, and 14 years. Visual acuity (VA) as measured by the Early Treatment Diabetic Retinopathy Study protocol was performed. Visual impairment (VI), defined as a VA of 20/40 or worse in the better eye; blindness, defined as a VA of 20/200 or worse in the better eye; and doubling of the visual angle were measured. Cumulative 14-year incidences of VI, doubling of the visual angle, and blindness were 12.7%, 14.2%, and 2.4%, respectively. In univariate analyses, loss of vision as measured by doubling of the visual angle is associated with older age, longer duration of diabetes, higher glycosylated hemoglobin, higher systolic and diastolic blood pressure, presence of proteinuria, more pack-years smoked, presence of macular edema, and more severe retinopathy. In logistic regression analyses, incidence of doubling of the visual angle is associated independently with retinopathy (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.03, 1.11 for each level), glycosylated hemoglobin (OR, 1.46; 95% CI, 1.28, 1.66 for each 1%), proteinuria (OR, 2.32; 95% CI, 1.39, 3.88 for presence), and age (OR, 1.45; 95% CI, 1.20, 1.75 for 10 years). In addition, a change in glycosylated hemoglobin from baseline to the 4-year examination is associated with loss of vision (OR, 1.15; 95% CI, 1.02, 1.30 for a 1% increase). Loss of vision continues to be significant in persons with diabetes. These results suggest that prevention of retinopathy through control of glycemia will have a beneficial effect on visual outcome.

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Sudden visual loss after removal of silicone oil.

Richard S B Newsom, Robert Johnston, Paul Sullivan … (2004)

Removal of silicone oil after vitreoretinal surgery reduces potential complications of glaucoma and cataract and improves visual function in 30% of patients. We report the clinical findings of a series of patients who experienced unexpected and permanent visual loss after removal of silicone oil.

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Author and article information

Contributors

Tan Wang: URI : https://loop.frontiersin.org/people/1758905/overview

Huan Chen: URI : https://loop.frontiersin.org/people/1821341/overview

Hanyi Min: URI : https://loop.frontiersin.org/people/1863192/overview

Journal

Journal ID (nlm-ta): Front Physiol

Journal ID (iso-abbrev): Front Physiol

Journal ID (publisher-id): Front. Physiol.

Title: Frontiers in Physiology

Publisher: Frontiers Media S.A.

ISSN (Electronic): 1664-042X

Publication date (Electronic): 23 June 2022

Publication date Collection: 2022

Volume: 13

Electronic Location Identifier: 915563

Affiliations

[1] ¹ Department of Ophthalmology , Peking Union Medical College Hospital , Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing, China

[2] ² Key Laboratory of Ocular Fundus Diseases , Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing, China

[3] ³ Operating Room , Peking Union Medical College Hospital , Chinese Academy of Medical Sciences and Peking Union Medical College , Beijing, China

Author notes

Edited by: Gaetano Santulli, Albert Einstein College of Medicine, United States

Reviewed by: Antonio Longo, University of Catania, Italy

Alexander E Berezin, Zaporizhia State Medical University, Ukraine

*Correspondence: Hanyi Min, minhy@ 123456pumch.cn

[ † ]

These authors have contributed equally to this work and share first authorship

This article was submitted to Clinical and Translational Physiology, a section of the journal Frontiers in Physiology

Article

Publisher ID: 915563

DOI: 10.3389/fphys.2022.915563

PMC ID: 9259924

SO-VID: ec18beb4-c333-4add-984f-e2d9badcf364

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This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Comparison of Retinal Changes Following Silicone Oil and Perfluoropropane Gas Tamponade for Proliferative Diabetic Retinopathy Patients

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Karger: Ophthalmology

Most cited references 29

Optical coherence tomography angiography

The 14-year incidence of visual loss in a diabetic population.

Sudden visual loss after removal of silicone oil.

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