July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
An Analysis and Characterization of Patients in the Bronx Undergoing Tractional Retinal Detachment Repair for Proliferative Diabetic Retinopathy
Author Affiliations & Notes
  • Max D Schlesinger
    Ophthalmology and Visual Sciences, Montefiore Medical Center, Lawrence, New York, United States
  • Anurag Shrivastava
    Ophthalmology and Visual Sciences, Montefiore Medical Center, Lawrence, New York, United States
  • Umar Mian
    Ophthalmology and Visual Sciences, Montefiore Medical Center, Lawrence, New York, United States
  • Joel Zonszein
    Endocrinology, Montefiore Medical Center, Bronx, New York, United States
  • Footnotes
    Commercial Relationships   Max Schlesinger, None; Anurag Shrivastava, None; Umar Mian, None; Joel Zonszein, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 1835. doi:
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    • Get Citation

      Max D Schlesinger, Anurag Shrivastava, Umar Mian, Joel Zonszein; An Analysis and Characterization of Patients in the Bronx Undergoing Tractional Retinal Detachment Repair for Proliferative Diabetic Retinopathy. Invest. Ophthalmol. Vis. Sci. 2018;59(9):1835.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : We aim in this pilot study to better understand the systemic profiles and overall health characteristics of diabetics with severe proliferative diabetic retinopathy requiring surgical intervention, with the eventual goal of a much larger analysis to help identify pertinent variables for our population in the Bronx, NY.

Methods : A retrospective chart review was performed on all patients who underwent pars plana vitrectomy (PPVx) for any diagnosis in 2015 by the Retina Service at Montefiore Medical Center in the Bronx, NY. Inclusion criteria for the study cohort were ICD-10 diagnostic codes for both Type 2 diabetes mellitus (T2DM) and tractional retinal detachment (TRD). A second cohort was created to serve as a control, consisting of a sampling of patients examined during the same calendar year who had ICD-10 codes for T2DM without retinopathy. Data were collected for both groups. Statistical significance was determined using either Fisher exact or unpaired T tests.

Results : See Image 1.

Conclusions : It is intuitive that significant differences exist between Type 2 diabetics with TRD requiring PPVx, and those without retinopathy. Surgical patients were far more likely to be on dialysis, use insulin, and require more medications to control concomitant hypertension. Counterintuitively, body mass-index proved not to be significantly different between the two groups. Furthermore, the Hemoglobin A1C in the surgical group at the time of surgery was not significantly higher than the non-surgical diabetic patients, yet the highest A1C recorded in the available chart was significantly higher; this may indicate that longer term fluctuations in glycemic control can have more of an impact on risk of progression, or that apprehension regarding upcoming surgery leads to short-term better glycemic control. A better understanding of the systemic profiles of diabetic patients with the most severe vision threatening disease will not only facilitate a more accurate assessment of relative risk, but allows for a unique window into the pathophysiology of end-organ vascular disease. Further research with more variables, larger samples and multivariate analyses offers the potential to create a risk calculator for severe diabetic eye disease.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Summary of Findings: Statistically Significant Differences Highlighted in Bold/Green

Summary of Findings: Statistically Significant Differences Highlighted in Bold/Green

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