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Norma Morales, Juan Carlos Serna-Ojeda, José Luis Rodriguez-Loaiza; Complications of Diabetic Retinopathy presented at the emergency department (ED) of a reference center in Mexico. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2916.
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© ARVO (1962-2015); The Authors (2016-present)
The frequency of complications of Diabetic Retinopathy (DR) at the ED is not clear and should be known to be prepared for immediate treatment. The purpose of this study is to determine the incidence of the complications of advanced stages of DR in our ED.
A retrospective analysis of patients attending our ED from June 2015 to May 2016, gathered independently of age and sex, and the diagnoses related to complications of advanced stages of DR were analyzed and categorized. These complications were considered as follows: clinically significant macular edema (CSME), proliferative diabetic retinopathy (PDR) with high risk characteristics, vitreous hemorrhage (VH), neovascular glaucoma (NVG) and traction retinal detachment (TRD). These diagnoses were categorized according to sex, age and number of complications. It was also included how many of these patients had already had previous treatment.
A total of 8395 visits to the ED were counted, of which 829 (9.9%) had complications of advanced stages of Diabetic Retinopathy, 423 (51%) being women and 406 (49%) men. The highest incidence of complications was found in 373 (45%) patients in the age group of 46 to 60 years. The most common complications were: VH in 514 (62%), PDR with high risk characteristics in 338 (41%), NVG in 236 (28%), CSME in 99 (12%), and TRD in 70 (8%) patients. Two simultaneous complications were found in 298 (36%) being VH + PDR the most common combination and 3 or more in 197 (24%) being VH + NVG + PDR the most frequent. Of all these patients, 212 (25.6%) had already had previous treatment, including 200 (94.3%) with panretinal photocoagulation, 8 (3.8%) with phacoemulsification and posterior vitrectomy and 4 (1.9%) with phacoemulsification with posterior vitrectomy and panretinal photocoagulation.
The incidence of sight threatening complications of advanced diabetic retinopathy is an important part of our ED consultations. The age group with highest incidence correlates to the statistics of the American Academy of Ophthalmology. It is necessary to strengthen patient education, as well as early ocular examination in diabetic patients and adequate follow up of diabetic retinopathy to prevent such complications.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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