Rate of Diabetic Vitrectomy in a Defined Geographical Part of North East England

Vaideanu, Daniela; Sandhu, Sukhpal S.; Ling, Jonathan; Richardson, John D.; Steel, David

doi:10.3109/09286586.2014.906628

Cited by 15 publications

(9 citation statements)

References 18 publications

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“…The prevalence of diabetes mellitus increased year on year since 2005-2018 from 3.6%-5.8%, which can partly account for the trend we observed 18 . However a group of researchers 19 found reducing rates of vitrectomy for all indications in diabetic patients in a well-defined geographic area in the North-East of England. They attributed this to better screening and early treatment of proliferative diabetic retinopathy.…”

Section: Tractional Retinal Detachmentmentioning

confidence: 99%

Increasing frequency of hospital admissions for retinal detachment and vitreo-retinal surgery in England 2000-2018

Madi¹,

Keller

2020

Preprint

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Objectives To analyse the changes in reported frequency of retinal detachment admissions and vitreo-retinal surgery procedures performed between 2000 and 2018 in England. To obtain information useful to contribute towards the planning of service delivery. Methods Analysis of England's Hospital Episode Statistics from the Health and Social Care Information Centre and population data from the United Kingdom's Office for National Statistics. Results Episodes of "retinal detachments with breaks" increased year on year from 3,447 (7.0/100M) in 2000 to 10,971 (19.7/100M) in 2018 (p <0.001), whereas records of "tractional retinal detachment" increased from 290 (0.6/100M) to 910 (1.6/100M) in the same period (p <0.0001). The number of reported pars plana vitrectomies irrespective of indication increased over fourfold from 5,761 to 26,900 (p <0.0001), while the number of scleral buckling records decreased by two thirds from 2,897 to 780 (p <0.0001). During the same period the population of England increased from 49.2 million to 55.6 million, proportionally at a slower rate than that for recorded hospital episodes. Conclusions The frequency of admissions to hospital for surgically treated retinal detachment seems to have been increasing significantly since 2000. This effect is more marked in cases of rhegmatogenous retinal detachment. This may be partially explained by repeat surgery in cases of recurrent retinal detachment. Other possible explanations may be increased incidence of disease (due to increased rates of cataract surgery, increasing longevity and increasing rates of myopia), improvements in patient access, and increased public awareness. It is possible that this observation is due in part to local changes in methodology of hospital coding.

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Section: Tractional Retinal Detachmentmentioning

confidence: 99%

Increasing frequency of hospital admissions for retinal detachment and vitreo-retinal surgery in England 2000-2018

Madi¹,

Keller

2020

Preprint

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“…The indications according to the American Academy of Ophthalmology (AAO) for a vitrectomy include the following: non‐clearing vitreous haemorrhage; significant recurring vitreous haemorrhage, despite use of maximal panretinal photocoagulation; dense premacular subhyaloid haemorrhage; tractional retinal detachment involving or threatening the macula; combined tractional and rhegmatogenous retinal detachment; red blood cell‐induced glaucoma and ‘ghost cell’ glaucoma; and anterior segment neovascularization with media opacities preventing panretinal photocoagulation (McCannel et al 2018). The yearly incidence of a vitrectomy in patients with PDR is estimated to be 6% (Vaideanu et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Long‐term outcomes of vitrectomy for proliferative diabetic retinopathy

Schreur

Brouwers

Huet

et al. 2020

Acta Ophthalmologica

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Purpose To investigate the long‐term outcomes of patients who underwent vitrectomy for proliferative diabetic retinopathy. Methods Cumulative incidences were calculated for low vision (<0.3), re‐vitrectomy in the study eye and fellow eye vitrectomy. To identify potential prognostic factors that associate with these outcomes, we used multivariable Cox regression models. Results In a total of 217 patients, we found 1‐, 5‐ and 10‐year cumulative incidences of low vision in the study eye of 24%, 31% and 39%, respectively. For both eyes, these rates were, respectively, 10%, 14% and 14%. Low vision in both eyes was associated with higher age and worse contralateral visual acuity. The 1‐, 5‐ and 10‐year cumulative incidences for re‐vitrectomy in the study eye were 16%, 27% and 27%, respectively, and for a vitrectomy in the fellow eye 24%, 40% and 54%, respectively. Re‐vitrectomy of the study eye was associated with worse contralateral visual acuity, while vitrectomy of the fellow eye was associated with shorter diabetes duration, worse contralateral visual acuity, higher HbA1c level and worse diabetic retinopathy severity stage of the fellow eye. Conclusion Functional visual acuity in at least one eye was achieved or preserved in most patients. After 10 years, about a quarter of all patients underwent a re‐vitrectomy, while more than half of the patients needed a vitrectomy of the fellow eye. Knowledge of these long‐term outcomes is essential when counselling patients for a vitrectomy.

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“…In a Northern English population, Vaideanu et al report that although the prevalence of diabetes had increased from 2.8-5.5% from 2000 to 2010, respectively, the rate of PDR within the diabetic population had reduced from 2.4-1.8% and the vitrectomy rate in these patients had reduced from 7.7-5.7% over the same time period 27 . This can be partly attributable to the introduction of screening, allowing patients to receive timely treatment prior to the development of sight threatening DR.…”

Section: Discussionmentioning

confidence: 99%

Management of Acute Proliferative Diabetic Retinopathy Related Complications During the First COVID-19 Wave

Dhillon

Santiago

2021

Preprint

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Background. Routine hospital eye services (HES) and diabetic retinal screening were paused during COVID lockdown in March 2020. Alternate pathways for managing acute ophthalmic pathology were devised in NHS Grampian: Emergency eye treatment centres (EETC) manned by community optometrists were set up to treat and triage referrals to HES. Methods. Retrospective study analysing patients referred to HES with proliferative diabetic retinopathy (PDR) related complications between March and August 2020. Results. 52 eyes of 46 patients with PDR related complications were identified. HES appointment had been delayed or cancelled in 43% due to COVID. Mean age was 54.5 years (± 15.1), 46% were female, 46% had type 1 diabetes; mean HbA1c was 78 mmol/l (± 18.7). Vision ranged from 6/6 to perception of light. 36 patients had unilateral vitreous haemorrhage (VH), 6 bilateral, 2 tractional retinal detachments and 3 had neovascular glaucoma. Following assessment, 23 eyes received anti-VEGF injection within 3 days, two had PRP on the same day, 16 were rebooked for urgent PRP, 13 referred for urgent surgical review and 17 advised observation. After a mean follow-up of 6 months, 12 eyes (23%) of 11 patients progressed to have vitrectomy. Conclusion. Despite lockdown, hospital appointment cancellations and recommended footfall reduction limiting capacity due to COVID19, patients reaching out with PDR complications were promptly referred to HES and appropriate treatments carried out with COVID precautions as recommended.

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Rate of Diabetic Vitrectomy in a Defined Geographical Part of North East England

Abstract: This study evaluated vitrectomy rates for PDR in an area of North East England. There were apparent declining rates of vitrectomy for PDR following the introduction of diabetic retinopathy screening but these have to be interpreted in the light of several confounding factors.

Cited by 15 publications

References 18 publications

Increasing frequency of hospital admissions for retinal detachment and vitreo-retinal surgery in England 2000-2018

Increasing frequency of hospital admissions for retinal detachment and vitreo-retinal surgery in England 2000-2018

Long‐term outcomes of vitrectomy for proliferative diabetic retinopathy

Management of Acute Proliferative Diabetic Retinopathy Related Complications During the First COVID-19 Wave

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