|
Current issue
Archive
Videos
Articles in press
About the journal
Supplements
Editorial board
Reviewers
Abstracting and indexing
Subscription
Contact
Instructions for authors
Publication charge
Ethical standards and procedures
Editorial System
Submit your Manuscript
|
1/2010
vol. 112 abstract:
Original paper
Combined surgical and pharmacological treatment of diabetic maculopathy
Jacek Robaszkiewicz
1
,
Katarzyna Chmielewska
1
,
Małgorzata Figurska
1
,
Małgorzata Frontczak-Baniewicz
2
,
Andrzej Stankiewicz
1
Online publish date: 2010/03/21
View
full text
Get citation
ENW EndNote
BIB JabRef, Mendeley
RIS Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
There are at least three avenues of investigation that support the theoretical value of vitrectomy for the treatment of DME, based on (1) vitrectomy with ILM peeling for the relief of traction on the macula, (2) vitrectomy to improve oxygenation of the macula leading to decreased vascular permeability with subsequent resolution or decrease in DME, and (3) ILM peeling to remove a part of the Müller cell endfeet and the horizontal gliosis. Visual improvement could be due to the induction of a higher overexpression of GFAP at the Müller cells level. It is likely that the proliferation of GFAP-stained gliofibrils, observed in these cells, preserves the blood-retinal barrier, reinforces architectural cohesion, and opposes the installation of the edema. In addition, the search for a specific pharmacological treatment is ongoing on the basis of new findings regarding the involvement of cytokines and growth factors in the formation of macular edema. Vascular endothelial growth factor (VEGF), inhibitors are currently being investigated in clinical studies. However, endogenous VEGF is required for visual function. Growing body evidence indicates that VEGF acts also on nonvascular cells, it plays survival role on Muller cells and photoreceptors. Therefore anti-VEGF therapies should be administered with caution.
keywords:
vitrectomy with ILM removal, gas SF6 endotamponade, Müller cells, retinal gliosis, VEGF inhibitors |
|
POLSKI
