Review Article

An update on the management of diabetic tractional retinal detachment

Aamina Hajee, Mokokomadi A. Makgotloe
African Vision and Eye Health | Vol 81, No 1 | a774 | DOI: https://doi.org/10.4102/aveh.v81i1.774 | © 2022 Aamina Hajee, Mokokomadi A. Makgotloe | This work is licensed under CC Attribution 4.0
Submitted: 08 May 2022 | Published: 30 August 2022

About the author(s)

Aamina Hajee, Department of Ophthalmology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
Mokokomadi A. Makgotloe, Department of Ophthalmology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa


Share this article

Bookmark and Share

Abstract

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.

 


Keywords

diabetes; diabetic retinopathy; tractional retinal detachment; pars plana vitrectomy; anti-vascular endothelial growth factor; endophotocoagulation

Metrics

Total abstract views: 248
Total article views: 144


Crossref Citations

No related citations found.