Necessity of Vitrectomy for Proliferative Diabetic Retinopathy Indicates High Mortality Risk for Young Male Diabetics

Abstract

Purpose: : Cumulated standard mortality ratio analysis to compare the life expectancy of diabetics requiring vitrectomy to those of general diabetics and of the general population.

Methods: : In a register-based, retrospective study we calculated the cumulated standard mortality ratios of 124 diabetics for each year up to 8 years after vitrectomy for proliferative diabetic retinopathy (PDR). As control population the age and gender adjusted Danish general population as well as a diabetic general population was used.

Results: : The 5-year survival rate of vitrectomized diabetics was 78.9%. 8 years after vitrectomy 22 patients had died. The mortality rates of all vitrectomized diabetics were 2.55-fold higher compared to the Danish general population and 1.47-fold higher compared to general diabetics. Of the young patients (vitrectomy under age 45) all deaths were of male sex. Young male diabetics had mortality rates up to 56-fold higher than the age adjusted general male population and up to 30-fold higher than the age adjusted male diabetic population. Although of young age their 5-year survival rate was 65.3%.

Conclusions: : So far the knowledge about life expectancies of a diabetic requiring vitrectomy was reduced to general 5-year survival rates. It was completely unknown to which extent this patient group has a lower life expectancy compared to another diabetic or to the general population. This is the first time a standard mortality ratio analysis was performed for vitrectomized diabetics. For over 45 year old diabetics the necessity of vitrectomy did not mean a relevant difference in survival, neither for females under 45 years of age. But for young male diabetics under 45 years of age the necessity of vitrectomy indicates a definite lower life expectancy.

Keywords: diabetic retinopathy • vitreoretinal surgery • clinical (human) or epidemiologic studies: prevalence/incidence