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Youngseok Song, Taiji Nagaoka, Akitoshi Yoshida, None.; SYSTEMIC RISK FACTORS IN CASES WITH BILATERAL PROLIFERATIVE DIABETIC RETINOPATHY REQUIRING VITRECTOMY COMPARED WITH MONOCULAR CASES. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5352.
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The rates of progression of diabetic retinopathy (DR) vary. Some patients progress to proliferative DR (PDR) and require bilateral vitrectomies, but some progress to PDR in just one eye. The systemic risk factors in both situations have never been studied. We investigated the systemic risk factors for bilateral vitrectomy in patients with bilateral PDR.
We retrospectively reviewed 87 consecutive patients with non-insulin-dependent diabetes mellitus with bilateral PDR who underwent surgery in our hospital. The cases were divided into two groups: bilateral group, in which both eyes underwent vitrectomy within 1 year of each other (n=25) and the unilateral group, in which only one eye underwent surgery (n=62). We examined the risk factors between the groups: age, sex, duration of diabetes, hemoglobin A1c, body mass index, estimated glomerular filtration rate (eGFR), uric albumin, hypertension, dyslipidemia, history of acute coronary syndrome/stroke, arteriosclerosis obliterans, smoking, and preoperative ocular findings that included intraocular-pressure, intravitreous hemorrhage, macular edema, and traction retinal detachment. We used the chi-square test and Mann-Whitney U test to analyze the data. All tests were two-tailed. P<0.05 was considered significant.
There were significantly fewer bilateral cases compared with unilateral cases with renal dysfunction (eGFR<30 ml/min/1.73m2. bilateral cases,=5/25; unilateral cases=3/62, P=0.041). No other significant differences in risk factors were identified between the groups.
Patients with PDR with renal dysfunction are likely to develop bilateral severe retinopathy.
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