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David H. Steel, Daniela Vaideanu, Sukhpal S. Sandhu; The Incidence Of Vitrectomy For The Complications Of Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5752.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the yearly incidence of diabetic vitrectomy in a defined geographical area in Northern England over an eleven year period and to assess the effect of a systematic diabetic retinopathy screening programme on the rate.
All patients undergoing vitrectomy for the complications of proliferative diabetic retinopathy(PDR) in the Sunderland and South Tyneside area (total population ~375,000) were recorded over an eleven year period from 2000 to 2010.Other indications for diabetic vitrectomy e.g. isolated diabetic macular oedema were excluded Yearly incidence rates for the total known diabetic population, the predicted total diabetic population and the population with PDR were calculated.A systematic screening programme for the detection of sight threatening retinopathy was introduced into the area in 2002
The mean observed prevalence of diabetes mellitus in the area ranged from 2.9% in 2000 to 5.9% in 2010 with the prevalence of known proliferative diabetic retinopathy within the diabetic population attending diabetic eye screening ranging from 1.3 to 1.1%. The mean predicted diabetic population ranged from 6.7% to 7.8% over the same time period.The mean incidence of vitrectomy for the complications of PDR in the known diabetic population was 0.14% (SD0.03, range 0.09-0.19) and 0.08% for the predicted diabetic population with a statistically significant gradual decline in the observed population rate from 0.16% to 0.12% (r = -0.66, p=0.027) but a fairly steady rate in the predicted population of 0.07% to 0.08% (p=0.48). The rate in the known PDR population ranged from 7.6% to 12% with 12% requiring vitrectomy in 2000 and 10.7% in 2010 (p=0.59).
The rate of vitrectomy observed in the population with PDR agrees with previous studies in real world populations. Following the introduction of screening in 2002 the rate in the known local diabetic population has gradually declined but the rate in the predicted diabetic population is surprisingly steady despite population level improvements in metabolic and hypertensive control. Some diabetic patients continue to require vitrectomy despite current recommended treatment and screening programmes being available and offered.
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