VITREOUS HEMORRHAGE - ATTITUDES IN MANAGE MENT, VITRECTOMY

Vitreous haemorrhage is a serious complication of proliferative diabet ic retinopathy : it provides evidence of the severity of at proliferat ive retinopathy at stake and precludes laser photocoagulation. In some cases of moderate vitreous haemorrhage, panretinal photocoagulation r emains possible especially using longer wavelengths such as krypton re d; cryotherapy under ophthalmoscopic control may be an alternative to panretinal photocoagulation. Developpement of pars plana vitrectomy, h owever, has been the main break the rough in the management of severe vitreous haemorrhage. Pars plana vitrectomy was first reserved to mass ive, long-standing vitreous haemorrhage; improvements in instrumentati on and techniques, as well as observations of the favourable effect of vitrectomy on the progression of proliferative retinopathy led to enl arger indications for pars plana vitrectomy. Beyond severity and durat ion of visual loss, main arguments for pars plana vitrectomy are bilat erality, lack of previous panretinal photocoagulation, iris neovascula rization, Type 1 diabetes, and severity of fibrovascular proliferation .