Abstract
Purpose :
Traction retinal detachment remains a leading cause of severe vision loss in those with diabetic retinopathy. The purpose of this study was to investigate factors in treatment history associated with outcomes of surgical repair for diabetic traction retinal detachments using a retrospective, observational clinical study.
Methods :
Sixty-four eyes that underwent surgical correction for diabetic traction retinal detachment were retrospectively analyzed. Change in best corrected visual acuity (BCVA) and factors associated with change in BCVA were the main outcome measures. For any eye that received treatment within three months of surgery, the entire treatment history was recorded and analyzed. Eyes with no recorded treatment or only remote treatment outside of three months prior to surgery were considered treatment naïve.
Results :
Of all eyes, 56% (n=36) had received treatment for proliferative diabetic retinopathy in the three months prior to surgery. Among those treated, 50% (n=18) of eyes had both laser and bevacizumab treatments and 44% (n=16) had only bevacizumab injections. One eye received only laser photocoagulation, and one eye received ranibizumab injections. Average BCVA for all eyes improved from 1.68 LogMAR (20/1000) preoperatively to 1.34 LogMAR (20/400) postoperatively, p=0.0017. Average BCVA in eyes with preoperative treatment history improved from 1.73 LogMAR (20/1000) preoperatively to 1.09 LogMAR (20/250) postoperatively, p=0.0006. Average BCVA in treatment-naïve eyes was 1.60 LogMAR (20/800) preoperatively and 1.66 LogMAR (20/1000) postoperatively, p=0.638. Eyes treated only with intravitreal injections had an improvement in BCVA from 1.81 LogMAR (20/1200) preoperatively to 0.91 LogMAR (20/160) postoperatively, p=0.006. There was no difference between tamponade agents when comparing mean change in BCVA, p=0.944.
Conclusions :
Bivariate analyses suggest there is a relationship between intravitreal injection treatment history and an improvement in BCVA, and a similar association between combined laser/injection treatment history and improvement in BCVA. These relationships however, were not present when controlling for confounders in multivariate analysis. There are likely other factors in the patients' treatment history such as timing, quantity, and order of treatments that play a role in the bivariate association observed in this study.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.