Abstract
BackgroundProliferative diabetic retinopathy (PDR) is one of the most common cause of vision loss in diabetic patients, and the incidence age of PDR patients gradually gets younger. This study aims to compare the characteristics of PDR and outcomes following vitrectomy in young and senior patients.MethodsThis is a retrospective case series study. Data of 116 eyes of 92 patients who underwent vitrectomy for PDR from February 2012 to February 2017 were reviewed, which were divided into young and senior patient groups. All patients were followed up for 24 months at least.ResultsThere were 62.1% of eyes with tractional retinal detachment secondary to PDR in the young patient group, while only 12.1% of eyes in the senior patient group with this surgery indication. (P < 0.001) The best corrected visual acuity increased in 41 eyes (70.7%), stable in 9 eyes (15.5%), and decreased in 8 eyes (13.8%) in young patients at the final follow-up. And it increased in 47 eyes (81.0%), stable in 2 eyes (3.4%), and decreased in 9 eyes (15.5%) in senior patients.(P = 0.085) Postoperative complications mainly included recurrent vitreous hemorrhage (24.1%), retinal detachment (3.4%), neovascular glaucoma (NVG) (27.6%) and nuclear sclerosis (53.4%) in young patients, and it was 19.0, 0.0, 1.7 and 3.4% in senior patients respectively.ConclusionPDR of young patients is more severe than that of senior patients, and vitrectomy is an effective and safe method for PDR treatment. NVG is a main and severe complication besides nuclear sclerosis in young patients, and the incidence of NVG is higher compared to that in senior patients.
Highlights
Proliferative diabetic retinopathy (PDR) is one of the most common cause of vision loss in diabetic patients, and the incidence age of PDR patients gradually gets younger
While one previous study reported rhegmatogenous retinal detachment (RRD) occurred in 4.3% patients after pars plana vitrectomy (PPV) with or without tamponade for recurrent vitreous hemorrhage (VH) caused by PDR [8]
Kwon et al reported in a recent study that the incidence of neovascular glaucoma (NVG) after vitrectomy was 11.8% in patients with VH associated with PDR [9]
Summary
Proliferative diabetic retinopathy (PDR) is one of the most common cause of vision loss in diabetic patients, and the incidence age of PDR patients gradually gets younger. As the incidence of diabetes mellitus (DM) persistently rises in China, proliferative diabetic retinopathy (PDR) has become the most common cause of vision loss in diabetic patients [1, 2]. While one previous study reported rhegmatogenous retinal detachment (RRD) occurred in 4.3% patients after PPV with or without tamponade for recurrent VH caused by PDR [8]. Kwon et al reported in a recent study that the incidence of NVG after vitrectomy was 11.8% in patients with VH associated with PDR [9]. Our previous study analyzed reasons for 10.2% (32/315 PDR eyes) with post-vitrectomy VH and found out the main reason was fibrovascular ingrowth [11]. The occurrence of early recurrent VH in another study was 24.3% without injection of ranibizumab [13]
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