EC Ophthalmology

Diabetes has been increasing both in incidence and prevalence throughout the world. New trends in nutrition and an easy going fast food behaviour, as well as genetic factors play a role in this increment.

Diabetic retinopathy, as a consequence, is more frequent in the office, and patients come due to low visual acuity secondary either to macular edema or complications of proliferative diabetic retinopathy, the first leading the retina specialist to treat the patient with laser, intraocular injections and the latter will oftenly end up leading the patients to the operating room, consequent to, usually, vitreous hemorrhages, retinal detachments and others.

Some patients are not treated adequately and consequently are diagnosed as severe proliferative diabetic retinopathy, and clinical treatment may not work and even after intraocular injections of antiangiogenics, develop the entity called Crush Syndrome, meaning they respond badly to intraocular injections, their retinopathy gets worse in less time than usual and many patients have to be taken right away towards surgical treatment.

Tie 2 is a tyrosine kinase receptor and in combination with vascular endothelial growth factor (VEGF) therapy make the outcome of diabetic retinopathy better. Drugs are also used for that purpose, and act as anti-VEGF, modulating the response of the patient with diabetic retinopathy and the above complications mentioned. The aim of this investigation is to propose a switch from clinical to surgical treatment when the patient develops this imbalance in the disease homeostasis, being diagnosed as Crush Syndrome.

Keywords: Diabetes; Diabetic Retinopathy; Vitreoretinal Surgery; Laser Photocoagulation; Vitrectomy; Intraocular Tamponades; Gas; Silicon Oil