POSTERIOR VITREOUS DETACHMENT STATUS AS A PREDICTIVE FACTOR FOR OUTCOMES OF VITRECTOMY FOR DIABETIC VITREOUS HEMORRHAGE. Issue 6 (June 2022)

• Record Type: Journal Article
• Authors: Tandias, Rachel; Lemire, Colin A.; Palvadi, Karishma; Arroyo, Jorge G.
• Is Part Of: Retina. Volume 42:Issue 6(2022)
• Page Start: 1103
• Page End: 1110
• Publication Date: 2022-06
• Subjects: diabetic retinopathy -- posterior vitreous detachment -- vitreoretinal adhesion -- vitreous hemorrhage; Retina -- Diseases -- Periodicals; Retinal Diseases; Vitreous Body; 617.735
• DOI: 10.1097/IAE.0000000000003453
• Languages: English
• ISSNs: 0275-004X

Abstract

Abstract : The extent of posterior vitreous attachment is a useful predictor of anatomical and functional outcomes after vitrectomy for diabetic vitreous hemorrhage. Extensive vitreoretinal adhesion is associated with higher rates of reoperation and poorer visual acuity outcomes compared with eyes with partial or complete posterior vitreous detachment. Abstract : Purpose: The purpose of this study was to evaluate the prognostic utility of the degree of vitreous attachment for predicting outcomes of vitrectomy for nonclearing vitreous hemorrhage associated with proliferative diabetic retinopathy. Methods: Medical records of patients who underwent primary vitrectomy for dense nonclearing vitreous hemorrhage secondary to proliferative diabetic retinopathy were examined retrospectively. Eyes were divided into four groups based on the intraoperatively assessed stage of posterior vitreous detachment (PVD), ranging from Stage 0/1 (complete or near-complete vitreoretinal adhesion) to Stage 4 (complete PVD). Results: Overall, 136 eyes (117 patients) were included. In comparison with eyes with a partial or complete PVD (Stages 2–4), eyes with no PVD (Stage 0/1) had a higher incidence of postoperative hypotony (8%, P = 0.03) and traction retinal detachment (27%, P = 0.002), an increased rate of repeat vitrectomy (49%, P = 0.04), and poorer best-corrected visual acuity at 6 months and 1 year postoperatively ( P = 0.04 and P = 0.01, respectively). Presence of a complete PVD at baseline was independently associated with improved postoperative vision at 6 months ( P = 0.04). Conclusion: More extensive vitreoretinal adhesion is associated with higher rates of reoperation and poorer visual outcomes after vitrectomy for dense nonclearing vitreous hemorrhage associated with proliferative diabetic retinopathy. Preoperative determination of PVD status using B-scan ultrasonography may be useful for predicting anatomical and functional outcomes after vitrectomy in these patients.