Purchase this article with an account.
Rebecca Broe, Jakob Grauslund, Anne K. Sjolie; The Need of Vitrectomy in Young Danish Type 1 Diabetic Patients - A 15-year Follow-up study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):987.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
The aim of this study was to examine the need for vitrectomy in a nationwide Danish cohort of young type 1 diabetic patients in order to explore the prognosis of diabetic eye disease in relation to glycemic control.
Eighty percent of all Danish type 1 diabetic patients below the age of 18 (n=720) were examined in 1986-89. In 1995 45 % of the original cohort (n=324) participated in a clinical follow-up study focusing on vascular complications. In 2010 we used the Danish Patient Register to determine, how many in the remaining cohort who had undergone vitrectomy and the date of their first surgery. This was correlated to the level of HbA1c, age, gender and diabetes duration. For comparison between groups the T-test was used.
Of the 324 patients, 37 (11%) had undergone vitrectomy at least once. This group consisted of 24 males (65%) and 13 females (35%) whereas the remaining patients (n=287) were 152 males (53%) and 135 (47%) females. We found a significant difference between the cases and controls in regards to gender (p<0.05).The two groups did not differ with regards to age and duration of diabetes. At the time of their first surgery the mean age of the 37 cases was 29.5 ± 4.9 years and the mean duration of DM was 22.7 ± 4.9 years. For the 37 vitrectomized patients, mean HbA1c in 1995 was 11.1 ± 1.9% which was significantly higher than for the remaining patients (mean HbA1c 9.9 ± 6.77 %, p<0.05). For the male patients in general, the glycemic control was significantly worse than for the female patients.
Our results indicate that high levels of HbA1c in childhood and adolescence increase the risk of severe diabetic retinopathy with a need of vitrectomy. One in ten patients had undergone vitrectomy in a 15-year follow-up of a population-based cohort of Danish type 1 diabetic patients. The mean age at the time of surgery was less than 30 years. High levels of HbA1c as well as male gender were identified as risk factors for incident vitrectomy.
This PDF is available to Subscribers Only