An update on the management of diabetic tractional retinal detachment

African Vision and Eye Health

Field Value
Title An update on the management of diabetic tractional retinal detachment
Creator Hajee, Aamina Makgotloe, Mokokomadi A.
Subject Ophthalmology diabetes; diabetic retinopathy; tractional retinal detachment; pars plana vitrectomy; anti-vascular endothelial growth factor; endophotocoagulation
Description Background: Tractional retinal detachment (TRD) occurs when contractile forces in the vitreous and neovascular tissue lead to the detachment of the neurosensory retina. The pre-operative use of antivascular endothelial growth factor (anti-VEGF) and advances in microsurgical instrumentation, such as a small gauge vitrectomy (SGV), have improved surgical outcomes.Aim: The purpose of this review is to highlight recent trends in the management of diabetic TRD, supporting earlier surgical intervention and the expanded surgical indications.Methods: PubMed was searched for the following terms: ‘diabetes’ OR ‘diabetic retinopathy’ AND ‘TRD’ AND ‘pars plana vitrectomy (PPV)’ AND ‘anti-VEGF’ AND ‘endophotocoagulation’. Reference lists were reviewed for additional articles. The review was focused on all articles later than 2010 for recent updates on the ever-changing management of this disease entity. No case reports were included in this review article.Results: Management of TRD continues to remain challenging, despite the recent advancements in techniques and instrumentation. Each case needs to be individualised, with careful pre-operative planning, understanding of patient expectations and counselling, coupled with meticulous surgical skills and diligent postoperative management.Conclusion: Management of TRD continues to remain challenging despite recent advances in techniques and instrumentation. Vitrectomy for TRD can improve vision-related quality of life, and the continued evolution and improvement in surgical techniques and adjunctive pharmacotherapy will most likely continue to improve postoperative outcomes.Contribution: The paper presents an overview of current management of tractional retinal detachment in patients with advanced proliferative diabetic retinopathy. 
Publisher AOSIS
Contributor none
Date 2022-08-30
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Review
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/aveh.v81i1.774
Source African Vision and Eye Health; Vol 81, No 1 (2022); 6 pages 2410-1516 2413-3183
Language eng
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Coverage South Africa, Africa, Gauteng 2022 —
Rights Copyright (c) 2022 Aamina Hajee, Mokokomadi A. Makgotloe