Evidence map›Paper›PMID 34708794›Full record

ArticleIndian journal of ophthalmology2021

A Delphi method based consensus statement for surgical management of proliferative diabetic retinopathy in India.

Sabyasachi Sengupta, Manavi D Sindal, P Mahesh Shanmugam, Pramod Bhende, Dhanashree Ratra, Manish Nagpal, Raja Narayanan, Anand Rajendran, Veerappan Saravanan, Aditya Kelkar and 4 more

Open access · diamondAbstract readConsensus Statement
In one paragraph

Article in Indian journal of ophthalmology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 10 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 7 institutions in 2 countries.

Sabyasachi SenguptaVitreoretinal Services, Future Vision Eye Care, Borivali (East), Mumbai, Maharashtra, India.
Manavi D SindalViitreoretinal Services, Aravind Eye Hospital, Puducherry, India.
P Mahesh ShanmugamVitreoretinal and Oncology Service, Sankara Eye Hospital, Kundalahalli Gate, Airport, Varthur Road, Bengaluru, Karnataka, India.
Pramod BhendeShri Bhagawan Mahavir Vitreo-Retinal Services, Medical Research Foundation, (Sankara Nethralaya), Chennai, Tamil Nadu, India.
Dhanashree RatraShri Bhagawan Mahavir Vitreo-Retinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Manish NagpalVitreo Retinal Consultant, Retina Foundation, Ahmedabad, Gujarat, India.
Raja NarayananKanuri Santhamma Centre for Vitreo Retinal Diseases, LV Prasad Eye Institute, Hyderabad, Telangana, India.
Anand RajendranVitreoretinal Services, Aravind Eye Hospital, Chennai, Tamil Nadu, India.
Veerappan SaravananVitreoretinal Services, Aravind Eye Hospital, Coimbatore, Tamil Nadu, India.
Aditya KelkarVitreo-Retinal Services, National Institute of Ophthalmology, Pune, Maharashtra, India.
Aniruddha MaitiVitreoretinal Services, Susrut Eye Foundation and Research Centre, Kolkata, West Bengal, India.
Debdulal ChakrabortyVitreo- Retina Service, Disha Eye Hospital, Barackpore, Kolkata, West Bengal, India.
Mohit DograVitreoretina and Uveitis Service, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Sourabh BeheraViitreoretinal Services, Aravind Eye Hospital, Puducherry, India.
Vasan Eye Care Hospital · INSankara Nethralaya · INAravind Eye Hospital · INEye Hospital in Bangalore · INL V Prasad Eye Institute · INNethradhama Superspeciality Eye Hospital · INPost Graduate Institute of Medical Education and Research · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo derive consensus statements for surgical management of proliferative diabetic retinopathy (PDR) for vitreoretinal (VR) surgeons.

methodsThirteen prolific VR surgeons representing all regions of India were invited to participate in a 42-point questionnaire based on the Delphi methodology describing various surgical scenarios commonly encountered in PDR. Consensus was derived using predefined robust analytics. Scenarios that returned a moderate consensus in round 1 were taken to round 2 as per the Delphi methodology. After considering all inputs, the final consensus criteria were developed.

resultsA strong consensus was derived about waiting for 4 weeks before considering vitrectomy. In treatment-naïve eyes with fresh vitreous hemorrhage (VH), the wait time was slightly shorter for extramacular tractional retinal detachment (2-4 weeks) and longer (4-6 weeks) for eyes treated previously with laser or anti-VEGF agents. The expert panel recommended using preoperative anti-VEGF only in eyes with large membranes requiring extensive dissection. For post vitrectomy VH, while a conservative approach was recommended for the first episode of VH, experts recommended immediate vitreous lavage for recurrent episodes of VH. In eyes with iris neovascularization, the panel recommended immediate anti-VEGF injection followed by early vitreous lavage in nonresponsive eyes. A strong consensus was derived for stopping antiplatelet agents before surgery, while there was only a moderate consensus for performing vitrectomy for recalcitrant macular edema unresponsive to anti-VEGF injections in the absence of traction.

conclusionThis study provides valuable consensus on managing the different scenarios encountered during surgical management of PDR and should help guide the VR surgeons in clinical decision-making.

Indexed as

Diabetes MellitusDiabetic RetinopathyConsensusHumansIndiaVitrectomyVitreous HemorrhageAnti VEGFdiabetic retinopathypars plana vitrectomytractional retinal detachmentvitreous hemorrhage

Identifiers

PMID34708794
PMCPMC8725119
OpenAlexW3210720407

What OpenQuestion holds

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LicenceCC BY-NC-SA
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.