Factors predicting visual improvement post pars plana vitrectomy for proliferative diabetic retinopathy

Abstract

AIM: To identify factors predicting visual improvement post vitrectomy for sequelae of proliferative diabetic retinopathy(PDR).METHODS: This was a retrospective analysis of pars plana vitrectomy indicated for sequelae of PDR from Jan. to Dec. 2014 in Hospital Sultanah Bahiyah, Alor Star, Kedah, Malaysia. Data collected included patient demographics, baseline visual acuity(VA)and post-operative logMAR best corrected VA at 1y. Data analysis was performed with IBM SPSS Statistics Version 22.0. RESULTS: A total of 103 patients were included. The mean age was 51.2y. On multivariable analysis, each pre-operative positive deviation of 1 logMAR from a baseline VA of 0 logMAR was associated with a post-operative improvement of 0.859 logMAR(P0.001). Likewise, an attached macula pre-operatively was associated with a 0.374(P=0.003)logMAR improvement post vitrectomy. Absence of iris neovascularisation and absence of post-operative complications were associated with a post vitrectomy improvement in logMAR by 1.126(P=0.001)and 0.377(P=0.005)respectively. Absence of long-acting intraocular tamponade was associated with a 0.302(P=0.010)improvement of logMAR post vitrectomy.CONCLUSION: Factors associated with visual improvement after vitrectomy are poor pre-operative VA, an attached macula, absence of iris neovascularisation, absence of post-operative complications and abstaining from use of long-acting intraocular tamponade. A thorough understanding of the factors predicting visual improvement will facilitate decision-making in vitreoretinal surgery.

Keywords

• vitrectomy
• vitreous hemorrhage
• tractional retinal detachment
• visual prognosis
• diabetic eye disease
• diabetic retinopathy
• diabetic retinopathy