Characteristics and outcomes of vitrectomy for proliferative diabetic retinopathy in young versus senior patients

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Abstract

Background

Proliferative diabetic retinopathy (PDR) is one of the most common cause of vision loss in diabetic patients, and the incidence age of PDR patients gradually gets younger. This study aims to compare the characteristics of PDR and outcomes following vitrectomy in young and senior patients.

Methods

This is a retrospective case series study. Data of 116 eyes of 92 patients who underwent vitrectomy for PDR from February 2012 to February 2017 were reviewed, which were divided into young and senior patient groups. All patients were followed up for 24 months at least.

Results

There were 62.1% of eyes with tractional retinal detachment secondary to PDR in the young patient group, while only 12.1% of eyes in the senior patient group with this surgery indication. ( P < 0.001) The best corrected visual acuity increased in 41 eyes (70.7%), stable in 9 eyes (15.5%), and decreased in 8 eyes (13.8%) in young patients at the final follow-up. And it increased in 47 eyes (81.0%), stable in 2 eyes (3.4%), and decreased in 9 eyes (15.5%) in senior patients.( P = 0.085) Postoperative complications mainly included recurrent vitreous hemorrhage (24.1%), retinal detachment (3.4%), neovascular glaucoma (NVG) (27.6%) and nuclear sclerosis (53.4%) in young patients, and it was 19.0, 0.0, 1.7 and 3.4% in senior patients respectively.

Conclusion

PDR of young patients is more severe than that of senior patients, and vitrectomy is an effective and safe method for PDR treatment. NVG is a main and severe complication besides nuclear sclerosis in young patients, and the incidence of NVG is higher compared to that in senior patients.

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Most cited references 29

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Diabetic retinopathy.

Ning Cheung, Paul Mitchell, Tien Wong (2010)

Diabetic retinopathy is a common and specific microvascular complication of diabetes, and remains the leading cause of preventable blindness in working-aged people. It is identified in a third of people with diabetes and associated with increased risk of life-threatening systemic vascular complications, including stroke, coronary heart disease, and heart failure. Optimum control of blood glucose, blood pressure, and possibly blood lipids remains the foundation for reduction of risk of retinopathy development and progression. Timely laser therapy is effective for preservation of sight in proliferative retinopathy and macular oedema, but its ability to reverse visual loss is poor. Vitrectomy surgery might occasionally be needed for advanced retinopathy. New therapies, such as intraocular injection of steroids and antivascular endothelial growth-factor agents, are less destructive to the retina than are older therapies, and could be useful in patients who respond poorly to conventional therapy. The outlook for future treatment modalities, such as inhibition of other angiogenic factors, regenerative therapy, and topical therapy, is promising. Copyright 2010 Elsevier Ltd. All rights reserved.

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Prevalence of diabetes among men and women in China.

Wenying Yang, Juming Lu, Jianping Weng … (2010)

Because of the rapid change in lifestyle in China, there is concern that diabetes may become epidemic. We conducted a national study from June 2007 through May 2008 to estimate the prevalence of diabetes among Chinese adults. A nationally representative sample of 46,239 adults, 20 years of age or older, from 14 provinces and municipalities participated in the study. After an overnight fast, participants underwent an oral glucose-tolerance test, and fasting and 2-hour glucose levels were measured to identify undiagnosed diabetes and prediabetes (i.e., impaired fasting glucose or impaired glucose tolerance). Previously diagnosed diabetes was determined on the basis of self-report. The age-standardized prevalences of total diabetes (which included both previously diagnosed diabetes and previously undiagnosed diabetes) and prediabetes were 9.7% (10.6% among men and 8.8% among women) and 15.5% (16.1% among men and 14.9% among women), respectively, accounting for 92.4 million adults with diabetes (50.2 million men and 42.2 million women) and 148.2 million adults with prediabetes (76.1 million men and 72.1 million women). The prevalence of diabetes increased with increasing age (3.2%, 11.5%, and 20.4% among persons who were 20 to 39, 40 to 59, and > or = 60 years of age, respectively) and with increasing weight (4.5%, 7.6%, 12.8%, and 18.5% among persons with a body-mass index [the weight in kilograms divided by the square of the height in meters] of or = 30.0, respectively). The prevalence of diabetes was higher among urban residents than among rural residents (11.4% vs. 8.2%). The prevalence of isolated impaired glucose tolerance was higher than that of isolated impaired fasting glucose (11.0% vs. 3.2% among men and 10.9% vs. 2.2% among women). These results indicate that diabetes has become a major public health problem in China and that strategies aimed at the prevention and treatment of diabetes are needed. 2010 Massachusetts Medical Society

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Impact of age, age at diagnosis and duration of diabetes on the risk of macrovascular and microvascular complications and death in type 2 diabetes

Sophia Zoungas, Mark Woodward, Qiang Li … (2014)

Data are inconsistent regarding the associations between age, age at diagnosis of diabetes, diabetes duration and subsequent vascular complications.

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Author and article information

Contributors

Hua Yan:

ORCID: http://orcid.org/0000-0001-9115-490X

phuayan2000@163.com

Journal

Journal ID (nlm-ta): BMC Ophthalmol

Journal ID (iso-abbrev): BMC Ophthalmol

Title: BMC Ophthalmology

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2415

Publication date (Electronic): 19 October 2020

Publication date PMC-release: 19 October 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 416

Affiliations

[1 ]GRID grid.412645.0, ISNI 0000 0004 1757 9434, Department of Ophthalmology, , Tianjin Medical University General Hospital, ; No.154 Anshan Road, Tianjin, 300052 China

[2 ]GRID grid.265021.2, ISNI 0000 0000 9792 1228, Laboratory of Molecular Ophthalmology, , Tianjin Medical University, ; Tianjin, China

[3 ]GRID grid.411249.b, ISNI 0000 0001 0514 7202, Department of Ophthalmology and Visual Sciences, , Federal University of São Paulo, ; São Paulo, Brazil

[4 ]GRID grid.410721.1, ISNI 0000 0004 1937 0407, Department of Ophthalmology, , University of Mississippi Medical Center, ; Jackson, USA

Author information

Hua Yan http://orcid.org/0000-0001-9115-490X

Article

Publisher ID: 1688

DOI: 10.1186/s12886-020-01688-3

PMC ID: 7574415

PubMed ID: 33076873

SO-VID: 0972e588-0f82-44d9-b5d5-eed473e16f5a

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 9 October 2019

Date accepted : 8 October 2020

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;

Award ID: 81830026

Award ID: 31871184

Award Recipient : Xiaohong Wang Hua Yan

Funded by: FundRef http://dx.doi.org/10.13039/501100006606, Natural Science Foundation of Tianjin City;

Award ID: 18ZXDBSY00030

Award Recipient : Hua Yan

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ScienceOpen disciplines: Ophthalmology & Optometry

Keywords: proliferative diabetic retinopathy,vitrectomy,young patients,neovascular glaucoma

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ScienceOpen disciplines: Ophthalmology & Optometry

Keywords: proliferative diabetic retinopathy, vitrectomy, young patients, neovascular glaucoma

Characteristics and outcomes of vitrectomy for proliferative diabetic retinopathy in young versus senior patients

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Karger: Ophthalmology

Most cited references 29

Diabetic retinopathy.

Prevalence of diabetes among men and women in China.

Impact of age, age at diagnosis and duration of diabetes on the risk of macrovascular and microvascular complications and death in type 2 diabetes

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