With diabetes rates at epidemic levels, proliferative diabetic retinopathy (PDR) continues to be a major public health burden. While vitrectomy is a potential treatment option, little is known about its long-term outcomes in these patients. Now, research suggests most maintain functional vision, although more than half also require surgery in the fellow eye.
For the 217 patients in the study, the researchers identified potential prognostic factors associated with major outcomes such as cumulative incidences for low vision, re-vitrectomy in the study eye and fellow eye vitrectomy. Key findings are as follows:
Cumulative Incidences at Follow-up Intervals
|Year 1||Year 5||Year 10|
|Low vision, study eye||24%||31%||39%|
|Low vision, both eyes||10%||14%||14%|
|Re-vitrectomy, study eye||16%||27%||27%|
|Vitrectomy, fellow eye||24%||40%||54%|
Older age and worse contralateral visual acuity were associated with low vision in both eyes. Worse contralateral visual acuity, a shorter diabetes duration, higher HbA1c level and worse disease severity stage of the fellow eye were associated with vitrectomy of the fellow eye.
The researchers note that functional visual acuity was achieved or preserved in at least one eye in most patients. “Knowing these long-term outcomes is essential when counselling patients for a vitrectomy,” they said in their paper.
Schreur V, Brouwers J, Van Huet RAC, et al. Long-term outcomes of vitrectomy for proliferative diabetic retinopathy. Acta Ophthalmologica. July 9, 2020. [Epub ahead of print].