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J.C. Law, A.G. Sharma, D. Eliott; Indications for Diabetic Vitrectomy in African Americans versus Caucasians . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3835.
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To determine the indications for primary diabetic vitrectomy in African Americans versus Caucasians.
A retrospective study was done on 322 consecutive patients requiring primary diabetic vitrectomy performed by one vitreoretinal surgeon at the Kresge Eye Institute. The indications for primary vitrectomy were categorized into 3 groups based on operative findings: (i) TRD/RRD (63/322)–combined tractional–rhegmatogenous retinal detachment (with or without vitreous hemorrhage); (ii) TRD (190/322)–tractional retinal detachment (with or without vitreous hemorrhage); and (iii) VH (69/322)–nonclearing vitreous hemorrhage only. Preoperative characteristics, diagnoses, and procedures were analyzed.
There were 247 vitrectomies among African American patients and 75 among Caucasian patients. There were 184 female and 138 male. Average age among African Americans was 54 years (range 15.5 to 82.8 years), and 53 years (range 25 to 82.1 years) for Caucasians. The relationship between indications for vitrectomy and gender or age was not statistically significant (p=0.71 and p=0.60, respectively). Twenty–three percent (56/247) of African Americans had TRD/RRD compared to 9.3% (7/75) of Caucasians; sixty percent (148/247) of African Americans had TRD compared to 56% (42/75) of Caucasians; vitreous hemorrhage alone was present in 17.4% (43/247) of African Americans and 34.7% (26/75) of Caucasians (p=0.001).
Patients of African American descent are more likely to have TRD/RRD as compared to Caucasians. TRD/RRD is an advanced complication of PDR, and African Americans may have a greater risk of developing this advanced complication. The most common indication for primary diabetic vitrectomy for both African Americans and Caucasians was tractional retinal detachment. The second most common indication in Caucasians was vitreous hemorrhage, but it was the least common indication among African Americans. Combined tractional–rhegmatogenous retinal detachments comprised only 19.6% of primary diabetic vitrectomies, and the majority (89%) were found in African Americans.
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