Abstract
Uncontrolled diabetes has been associated with progression of diabetic retinopathy (DR) in several studies. Therefore, we aimed to investigate systemic and ophthalmic factors related to worsening of DR even after completion of panretinal photocoagulation (PRP). We retrospectively reviewed DR patients who had completed PRP in at least one eye with a 3-year follow-up. A total of 243 eyes of 243 subjects (mean age 52.6 ± 11.6 years) were enrolled. Among them, 52 patients (21.4%) showed progression of DR after PRP (progression group), and the other 191 (78.6%) patients had stable DR (non-progression group). The progression group had higher proportion of proliferative DR (P = 0.019); lower baseline visual acuity (P < 0.001); and higher platelet count (P = 0.048), hemoglobin (P = 0.044), and hematocrit, (P = 0.042) than the non-progression group. In the multivariate logistic regression analysis for progression of DR, baseline visual acuity (HR: 0.053, P < 0.001) and platelet count (HR: 1.215, P = 0.031) were identified as risk factors for progression. Consequently, we propose that patients with low visual acuity or high platelet count are more likely to have progressive DR despite PRP and require careful observation. Also, the evaluation of hemorheological factors including platelet counts before PRP can be considered useful in predicting the prognosis of DR.
Highlights
Uncontrolled diabetes has been associated with progression of diabetic retinopathy (DR) in several studies
Panretinal photocoagulation (PRP) has been the main treatment to prevent severe vision loss in patients with severe nonproliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) according to the findings of studies on DR, and the effectiveness of the treatment was confirmed by the early treatment diabetic retinopathy study (ETDRS)[6]
This study investigated the predictive markers for DR progression in patients after completion of panretinal photocoagulation (PRP)
Summary
Uncontrolled diabetes has been associated with progression of diabetic retinopathy (DR) in several studies. There were a few studies that have focused on systemic factors associated with worsening of PDR after completion of P RP8. We aimed to explore systemic factors related to worsening of PDR after completion of PRP using the clinical data warehouse (CDW) system. To explore the large database of clinical information of patients with PDR, we used the CDW system of the hospital, which is an electronic data repository of patient and provider information. This is one of the largest studies on the association of systemic conditions such as comorbid diseases with PDR utilizing clinical data and laboratory test results in Asians. The findings of this study are expected to provide insight into the pathogenesis of PDR progression
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