Factors correlated with visual outcomes at two and four years after vitreous surgery for proliferative diabetic retinopathy

Abstract

Proliferative diabetic retinopathy (PDR) is the most severe case of diabetic retinopathy that can cause visual impairment. This study aimed to reveal the factors correlated with better postoperative visual acuity after a long follow-up in patients who underwent vitrectomy for PDR. We retrospectively analyzed the data set including systemic findings, ocular findings, and surgical factors from registered patients who could be completely followed up for 2 or 4 years after vitrectomy. We ultimately enrolled 128 eyes from 100 patients who underwent vitrectomy for PDR between January 2008 and September 2012 and were followed up for >2 years. Among them, 91 eyes from 70 patients could be followed up for 4 years. Factors related to the postoperative visual acuity of ≥20/40 and ≥20/30 after 2 and 4 years were investigated by logistic regression analysis. Better postoperative visual acuity correlated with the following factors: no rubeosis iridis ([≥20/40 at 2 years; odds ratio {OR}, 0.068; 95% confidence interval {CI}, 0.012–0.39; P = 0.003], [≥20/30 at 2 years; OR, 0.07; 95% CI, 0.01–0.40; P = 0.03], [≥20/30 at 4 years; OR, 0.078; 95% CI, 0.006–0.96; P = 0.04]), no fibrovascular membrane [(≥20/40 at 2 years; OR, 0.22; 95% CI, 0.061–0.81; P = 0.02), (≥20/40 at 4 years; OR, 0.26; 95% CI, 0.07–0.94; P = 0.04), (≥20/30 at 4 years; OR, 0.14; 95% CI, 0.04–0.52; P = 0.004)], existing vitreous hemorrhage (≥20/30 at 2 years; OR, 9.55; 95% CI, 1.03–95.27; P = 0.04), and no reoperation ([≥20/40 at 4 years; OR, 0.15; 95% CI, 0.03–0.78; P = 0.02], [≥20/30 at 4 years; OR, 0.06; 95% CI, 0.07–0.54; P = 0.01]). Treatment provision before disease severity and treatment without complications were associated with good postoperative visual acuity.

Clinical features and surgical outcomes of complications of proliferative diabetic retinopathy in young adults with type 1 diabetes mellitus versus type 2 diabetes mellitus - A comparative observational study

“…[ 27 ] Nishi et al . [ 28 ] found an association between the systemic risk factors and visual acuity at 2 and 4 years following vitrectomy for PDR which is similar to our findings of the association between hypertension and the final visual outcome in the T2DM group.…”

Prediction of Visual Outcomes After Diabetic Vitrectomy Using Clinical Factors From Common Data Warehouse

“…These factors were reported also to be predictors for poor vision in previous studies. 7 , 19 , 20 Conversely, vitreous hemorrhage was reported to be a protective factor, and this was made evident again in the current study. The duration of T2DM treatment at the referral hospital was also a protective factor in this study.…”

Relationship between renal function and prognosis of Chinese proliferative diabetic retinopathy patients undergoing the first vitrectomy: protocol for a prospective cohort study

“…According to the previous literature report, 37 it is estimated that the occurrence rates of poor vision at 6 months in the DKD group (glomerular filtration rate lower than 60 mL/(min 1.73 m 2 )) and the non-DKD group are 0.077 and 0.206, respectively. PASS V.15 software (PASS 15.0.5 NCSS, LLC, USA) was adopted to calculate the experimental size of the DKD group and the non-DKD group: N1=N2=149 cases.…”

“… 38 The scheme we adopt has been described previously. 37 BCVA changes in comparison with the preoperative value at each follow-up visit will be recorded and divided into three categories. An increase of＞0.3 logMAR unit, a change of <0.3 logMAR unit and a decrease of＞0.3 logMAR unit will be defined as ‘improvement’, ‘invariant’ and ‘worsening’, respectively.…”