Investigation of the recurrent vitreous hemorrhage risk factors after early 25G vitrectomy in diabetic vitreous hemorrhage.
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
19 Jan 2024
19 Jan 2024
Historique:
medline:
19
1
2024
pubmed:
19
1
2024
entrez:
19
1
2024
Statut:
ppublish
Résumé
Vitreous hemorrhage (VH) is one of the main causes of vision loss in diabetic retinopathy (DRP). Early surgery increases the visibility of the retina, allowing early recognition of DRP complications and additional treatments. One of the most important reasons affecting success after surgery is recurrent vitreous hemorrhage (RVH). We aimed to investigate the risk factors for RVH after early 25G vitrectomy in diabetic VH. Eighty eyes of eighty patients who underwent early 25G PPV surgery with a diagnosis of VH due to proliferative diabetic retinopathy (PDR) were included in this retrospective study. Vision acuity changes and intraocular pressure (IOP) changes were compared. The effect of arterial hypertension (HT), coronary artery disease (CAD), preoperative antiglaucomatous usage, and anticoagulant usage on RVH was investigated. A value of P < .05 was accepted as statistically significant. Postoperative RVH was observed in 18 (22.5%) patients. There was no correlation between the age of the patients and the development of postoperative RVH (r = -0.197, P = .08). The rate of HT and the mean HbA1C levels were found to be higher in the patients who developed RVH than in those who did not (P = .04 and < 0.001, respectively). The presence of CAD, preoperative glaucoma disease, and the use of anticoagulants did not have any effect on RVH (P = .229, 0.843, 0.932, respectively). HT and increased HbA1c were found to be risk factors for RVH in VH patients who underwent 25G vitrectomy in the early period in our study.
Identifiants
pubmed: 38241585
doi: 10.1097/MD.0000000000036963
pii: 00005792-202401190-00060
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e36963Informations de copyright
Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no funding and conflicts of interest to disclose.
Références
Spraul CW, Grossniklaus HE. Vitreous hemorrhage. Surv Ophthalmol. 2019;42:3–39.
Chelala E, Nehme J, El Rami H, et al. Efficacy of intravitreal ranibizumab injections in the treatment of vitreous hemorrhage related to proliferative diabetic retinopathy. Retina. 2018;38:1127–33.
Spaide RF, Fisher YL. Intravitreal bevacizumab (Avastin) treatment of proliferative diabetic retinopathy complicated by vitreous hemorrhage. Retina. 2006;26:275–8.
El Annan J, Carvounis PE. Current management of vitreous hemorrhage due to proliferative diabetic retinopathy. Int Ophthalmol Clin. 2014;54:141–53.
Diabetic Retinopathy Vitrectomy Study Research Group. Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy: four-year results of a randomized trial: diabetic retinopathy study report 5. Arch Ophthalmol. 1990;108:958–64.
Mason JO, Colagross CT, Vail R. Diabetic vitrectomy: risks, prognosis, future trends. Curr Opin Ophthalmol. 2006;17:281–5.
Sima P, Zoran T. Long-term results of vitreous surgery for proliferative diabetic retinopathy. Doc Ophthalmol. 1994;87:223–32.
Soto-Pedre E, Hernaez-Ortega MC, Vazquez JA. Risk factors for postoperative hemorrhage after vitrectomy for diabetic retinopathy. Ophthalmic Epidemiol. 2005;12:335–41.
Mahalingam P, Topiwalla T, Ganesan G. Vitreous rebleed following sutureless vitrectomy: incidence and risk factors. Indian J Ophthalmol. 2018;66:558–61.
Diabetic Retinopathy Vitrectomy Study Research Group. Two-year course of visual acuity in severe proliferative diabetic retinopathy with conventional management Diabetic Retinopathy Vitrectomy Study (DRVS) Report 1. Ophthalmology. 1985;92:492–502.
Lee BJ, Yu HG. Vitreous hemorrhage after the 25-gauge transconjunctival sutureless vitrectomy for proliferative diabetic retinopathy. Retina. 2010;30:1671–7.
Sato T, Tsuboi K, Nakashima H, et al. Characteristics of cases with postoperative vitreous hemorrhage after 25-gauge vitrectomy for repair of proliferative diabetic retinopathy. Graefes Arch Clin Exp Ophthalmol. 2017;255:665–71.
Yorston D, Wickham L, Benson S, et al. Predictive clinical features and outcomes of vitrectomy for proliferative diabetic retinopathy. Br J Ophthalmol. 2008;92:365–8.
Smith JM, Steel DHW. Anti-vascular endothelial growth factor for prevention of postoperative vitreous cavity haemorrhage after vitrectomy for proliferative diabetic retinopathy. Cochrane Database Syst Rev. 2015;2015:CD008214.
Bhende M, Agraharam SG, Gopal L, et al. Ultrasound biomicroscopy of sclerotomy sites after pars plana vitrectomy for diabetic vitreous hemorrhage. Ophthalmology. 2000;107:1729–36.
Krieger AE. The pars plana incision: experimental studies, pathologic observations, and clinical experience. Trans Am Ophthalmol Soc. 1991;89:549–621.
Ostri C, La Cour M, Lund-Andersen H. Diabetic vitrectomy in a large type 1 diabetes patient population: long-term incidence and risk factors. Acta Ophthalmol. 2014;92:439–43.
Khuthaila MK, Hsu J, Chiang A, et al. Postoperative vitreous hemorrhage after diabetic 23-gauge pars plana vitrectomy. Am J Ophthal. 2013;155:75763.
Brown JS, Mahmoud TH. Anticoagulation and clinically significant postoperative vitreous hemorrhage in diabetic vitrectomy. Retina. 2011;31:1983–7.
Fabinyi DC, O’Neill EC, Connell PP, et al. Vitreous cavity haemorrhage post-vitrectomy for diabetic eye disease: the effect of perioperative anticoagulation and antiplatelet agents. Clin Exp Ophthalmol. 2011;39:878–84.