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Shripaad Shukla, Karina Shah, Ravi Nayak, Seenu M Hariprasad; Long-Term Mortality in Diabetics with Tractional Retinal Detachments. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1589.
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© 2017 Association for Research in Vision and Ophthalmology.
It is known that diabetics have a higher mortality rate than non-diabetics; but, specific data on mortality rates for the most poorly controlled diabetics with tractional retinal detachments (TRD) is not known. This study sought to determine the long-term, all-cause mortality rate of diabetics requiring vitrectomy surgery for TRD.
We performed a retrospective comparative study of long-term, all-cause mortality in diabetics with TRD undergoing vitrectomy surgery from 2005 to 2015 (315 patients) compared to mortality in a historical control of diabetics with minimal to no retinopathy. Sub-group analysis was done based on bilaterality of TRD and initial vision. Student t-test was done for statistical analysis. Data was used to create Kaplan-Meier survival curves.
The mean age at TRD diagnosis for all patients with diabetic TRDs requiring vitrectomy surgery was 56.0 years (median 57.0 years, range 22-87 years), while the mean age at TRD diagnosis for diabetics requiring vitrectomy surgery who died was not statistically different at 59.8 years (median 60.5 years, range 22-87 years) (p-value 0.1). The mean age for diabetics requiring vitrectomy surgery who did not die was 54 years (median 54 years, range 23-83 years), which was also not statistically different (p-value 0.12). Mean survival after diagnosis of TRD was 2.3 years (median 2 years, range 0.17-8 years). Kaplan-Meier survival curve analysis revealed a 43.8% (138/315 patients) long-term, all-cause mortality rate for diabetics requiring vitrectomy surgery for TRDs at 10 years, as compared to a mean 2% long-term, all-cause mortality rate in diabetics with minimal to no retinopathy. The 5-year Kaplan-Meier long-term, all-cause mortality rate for diabetics requiring vitrectomy surgery for TRDs was 27.9%. Sub-group analysis of those patients with bilateral TRDs requiring surgery revealed a 44.9% mortality rate. For patients with bilateral TRDs, mean survival after diagnosis of TRD was 2.4 years (median 2 years, range 0.25-6 years). No correlation was found with bilaterality of TRDs or initial presenting vision and mortality rate (p-values > 0.05).
Diabetics with tractional retinal detachments requiring surgery have at least a 43.8% long-term, all-cause mortality rate. Diabetic TRD requiring vitrectomy surgery is a marker of poor long-term survival.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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