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

Abstract

IntroductionChina has the largest number of adults with diabetes aged 20–79 years (116.4 million) in 2019. Due to the socioeconomic condition or a lack of awareness of diabetic complications, many adults with diabetes have proliferative diabetic retinopathy (PDR) or renal function impairment at their first visit to the clinic for a sudden loss of vision, and pars plana vitrectomy (PPV) is required for their treatment. Risk factors for the outcomes and complications of PPV surgery in PDR patients have been widely explored in many epidemiological studies and clinical trials. However, few prospective studies have analysed the association between renal function and surgical outcomes in PDR.Methods and analysisThis is a single-centre, prospective cohort study of PDR patients with type 2 diabetes mellitus who have definite indications for PPV surgery with or without renal function impairment. We will consecutively enrol PDR patients who meet the inclusion and exclusion criteria from November 2020 to December 2023. Each participant will be followed up for at least 6 months after surgery. Clinical data from medical records and vitreous fluid will be collected.Demographic characteristics and study outcomes will be summarised using descriptive statistics. The variation will be described and evaluated using the χ² test or Kruskal-Wallis test. Generalise additive mixed models will be used to explore the association between the renal profile and surgical outcomes including BCVA, and retinal and choroidal microvasculature/microstructure. Multivariate ordinal regression analysis will be used to detect the independent association between renal profile and BCVA changes, and smooth curve fitting will be employed to briefly present the tendency.Ethics and disseminationThe trial has received ethical approval from the West China Hospital of Sichuan University. Results of this trial will be disseminated through publication in peer-reviewed journals and presentations at local and international meetings.Trial registration numberChiCTR2000039698.

Association of plasma vitamin A level with type 2 diabetes mellitus: a community aging population-based cross-sectional study

“…Meanwhile, the number of diabetics continues to rise rapidly. It is predicted that the number of diabetes patients in China will reach 147.2 million in 2045 [3] . Recently, a meta-analysis showed a signifi cant correlation between diabetes and the increased risk of cardiovascularrelated diseases, such as coronary heart disease, myocardial infarction and cerebral infarction [2] .…”

Same-Day Cancellation is Higher in Outpatient Pars Plana Vitrectomy for Proliferative Diabetic Retinopathy

“…As the number of DM cases in China continues to increase, DR is becoming more common. 2 Due to the lack of awareness of diabetic complications and imperfections in community health management, patients who visit the hospital with vision loss as the main complaint are usually in the PDR stage with retinal neovascularization, fibrous proliferation, and traction retinal detachment. The pars plana vitrectomy (PPV) is a cost-effective long-term stabilizing treatment for vision preservation in PDR patients.…”