Surgical outcomes of vitrectomy surgery for proliferative diabetic retinopathy in patients with abnormal renal function

Li²,

Evidence-Based Complementary and Alternative Medicine

et al. 2021

Objective. To explore the effects of the anti-VEGF drug and glucocorticoid by injection before the end of vitrectomy for proliferative diabetic retinopathy (PDR). Methods. Eighty PDR patients who underwent vitrectomy in our hospital (July 2020–June 2022) were selected as the research objects and randomized into group A (n = 40) and group B (n = 40) according to the order of admission. Before the end of surgery, group B was injected with glucocorticoid (triamcinolone acetonide) into the vitreous cavity, and group A was injected with anti-VEGF drug (conbercept). The ophthalmic parameters, incidence of complications, diabetes indexes, and surgical indexes of the two groups were compared. Results. The best corrected visual acuity (BCVA), central macular thickness (CMT), macular blood flow density and intraocular pressure in group A were remarkably better than those in group B ( P < 0.001 ). The incidence of complications ( P < 0.05 ) and VEG/F level ( P < 0.001 ) in group A were obviously lower than those in group B. There was no significant difference in fasting blood glucose (FBG) and surgical indexes between the two groups ( P > 0.05 ). Conclusion. Conbercept injection before the end of vitrectomy can improve the ophthalmic parameters, reduce the level of VEGF, and lower the possibility of postsurgical complications. Therefore, the low-cost and efficient anti-VEGF drug should be promoted and applied in practice.

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of the Effects of the Anti-VEGF Drug and Glucocorticoid by Injection before the End of Vitrectomy for Proliferative Diabetic Retinopathy

Li²,

Evidence-Based Complementary and Alternative Medicine

et al. 2021

“…Impact of micro albuminuria is always there on retinopathy and outcome. 10 BCVA mentioned in our study were after removal of silicone oil. Elevated urinary albumin excretion has been found to increase the risk of proliferative diabetic retinopathy (PDR) and is associated with a higher prevalence of PDR.…”

Section: Discussionmentioning

confidence: 60%

Outcome of Vitrectomy in Proliferative Diabetic Retinopathy Patients with Diabetic Nephropathy- A Retrospective Study at Tertiary Eye Centre, Telangana State, in South India

Sultana¹

2020

jemds

A B S T R A C T BACKGROUNDThe increase in prevalence of diabetes in India is one of the leading causes of blindness due to micro vascular and macro vascular complications. The complications in retina and kidney are due to damage of small vessels. Studies have shown significant association between diabetic retinopathy and diabetic nephropathy. In our study, we are discussing the complications during intra and post-operative period and also both anatomical and functional outcome in these patients after vitrectomy for proliferative diabetic retinopathy. Both eye and kidney share same vascular pattern. One pre-existing condition can be followed by the other condition due to similar microvascular damage. We wanted to evaluate the outcome of vitrectomy in proliferative diabetic retinopathy patients associated with chronic kidney disease.

“… 20 , 24 However, this result requires further validation as estimated glomerular filtration rate, an important parameter for kidney function, did not correlate with visual outcome after diabetic vitrectomy. 25 Other factors identified as important predictors in the machine learning model, such as liver function and smoking, should similarly be studied in depth in subsequent studies.…”

Section: Discussionmentioning

confidence: 99%

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

Lee

Chang

Kwon

et al. 2022

Trans. Vis. Sci. Tech.

Purpose We sought to analyze the visual outcome and systemic prognostic factors for diabetic vitrectomy and predicted outcomes using these factors. Methods This was a multicenter electronic medical records (EMRs) review study of 1504 eyes with type 2 diabetes that underwent vitrectomy for proliferative diabetic retinopathy at 6 university hospitals. Demographics, laboratory results, intra-operative findings, and visual acuity (VA) values were analyzed and correlated with visual outcomes at 1 year after the vitrectomy. Prediction models for visual outcomes were obtained using machine learning. Results At 1 year, VA was 1.0 logarithm of minimal angle resolution (logMAR) or greater (poor visual outcome group) in 456 eyes (30%). Baseline visual acuity, duration of diabetes treatment, tractional membrane, silicone oil tamponade, smoking, and vitreous hemorrhage correlated with logMAR VA at 1 year (r = 0.450, −0.159, 0.221, 0.280, 0.067, and −0.105; all P ≤ 0.036). An ensemble decision tree model trained using all variables generated accuracy, specificity, F1 score (the harmonic means of which precision and sensitivity), and receiver-operating characteristic curve area under curve values of 0.77, 0.66, 0.85, and 0.84 for the prediction of poor visual outcomes at 1 year after vitrectomy. Conclusions Visual outcome after diabetic vitrectomy is associated with pre- and intra-operative findings and systemic factors. Poor visual outcome after diabetic vitrectomy was predictable using clinical factors. Intensive care in patients who are predicted to result in poor vision may limit vision loss resulting from type 2 diabetes. Translational Relevance This study demonstrates that a real world EMR big data could predict outcome after diabetic vitrectomy using clinical factors.