Diabetic vitrectomy in a large type 1 diabetes patient population: long‐term incidence and risk factors. (3rd August 2013)

• Record Type: Journal Article
• Authors: Ostri, Christoffer; la Cour, Morten; Lund‐Andersen, Henrik
• Is Part Of: Acta ophthalmologica. Volume 92:Number 5(2014)
• Page Start: 439
• Page End: 443
• Publication Date: 2013-08-03
• Subjects: Ophthalmology -- Periodicals; 617.7005
• DOI: 10.1111/aos.12249
• Languages: English
• ISSNs: 1755-375X

Abstract

<abstract abstract-type="main" id="aos12249-abs-0001"> <title>Abstract</title> <sec id="aos12249-sec-0001" sec-type="section"> <title>Purpose</title> <p>Diabetic vitrectomy represents an end‐point of diabetic retinopathy progression. This study was designed to estimate long‐term incidence of diabetic vitrectomy and associated risk factors.</p> </sec> <sec id="aos12249-sec-0002" sec-type="section"> <title>Methods</title> <p>Retrospective review of prospectively collected data from a large diabetes centre between 1996 and 2010. Surgical history was obtained from The Danish National Patient Register.</p> </sec> <sec id="aos12249-sec-0003" sec-type="section"> <title>Results</title> <p>The population consisted of 3980 patients with type 1 diabetes. Median follow‐up was 10.0 years. In total, 106 patients underwent diabetic vitrectomy in the observation period. Surgery indications were nonclearing vitreous haemorrhage (43%) or tractional retinal detachment (57%). The cumulative incidence rates of diabetic vitrectomy were 1.6% after 5 years and 2.9% after 10 years. When excluding patients with no or mild diabetic retinopathy, the corresponding rates were higher; 3.7% and 6.4%, respectively (p < 0.001, log‐rank test). The risk of reaching diabetic vitrectomy increased in patients experiencing glycosylated haemoglobin A1c > 75 mmol/mol in the observation period (p < 0.001, hazard ratio: 3.9, Cox regression analysis). Systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, diabetes duration, age, gender and nephropathy were not associated with an increased risk of reaching diabetic vitrectomy (p > 0.05 for all variables).</p> </sec> <sec id="aos12249-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Diabetic vitrectomy is rarely required in a type 1 diabetes population with varying degrees of retinopathy, but the risk increases markedly with poor metabolic control.</p> </sec> </abstract>