Trends for Proliferative Diabetic Retinopathy Vitrectomy Treatments in the IRIS^® Registry (Intelligent Research in Sight)

Abstract

Purpose : Vitrectomies are necessary for treating non-clearing vitreous hemorrhage and tractional retinal detachments. We used the IRIS Registry to better understand vitrectomy rates and demographics that predict which Proliferative Diabetic Retinopathy (PDR) patients would be more likely to undergo a vitrectomy.

Methods : We identified patients with PDR between the years of 2016-2018 in the IRIS Registry and calculated the percentage of eyes with PDR undergoing vitrectomy each year. Multivariate regression was performed to identify how patient sex, age, and race/ethnicity as well as diagnosis influence odds of undergoing vitrectomy. We also compared the number of intravitreal anti-VEGF injections between 2016-2018 for eyes with PDR who underwent and did not undergo vitrectomy in 2018.

Results : Percentage of PDR eyes undergoing vitrectomies between 2016-2018 was 2.27% in 2016, 2.12% in 2017, and 2.40% in 2018 (Table 1). After adjusting for confounders, ages 41-60 (OR 3.0, 95% CI 2.59 - 3.48) and ages 61-40 (OR 2.72, 95% CI 2.42 - 3.05) had the highest odds of undergoing vitrectomy compared to patients aged 21-40. Similarly, compared with White race, Hispanics (OR 1.26, 95% CI 1.19 - 1.34) had the highest adjusted odds of undergoing vitrectomy and Asians (OR 0.72, 95% CI 0.62 - 0.83) and Blacks (OR 0.75, 95% CI 0.71 - 0.80) had the lowest. The mean number of injections for PDR patients who underwent and did not undergo vitrectomy in 2018 was respectively 2.96 and 0.93 (p < 0.001).

Conclusions : Within the IRIS Registry, there was no clear trend in the percentage of eyes with PDR undergoing vitrectomy between 2016, 2017, and 2018. Patients ages 41-60 were the most likely to undergo vitrectomy, possibly as a result of surgical candidacy. Interestingly, Hispanic patients had a 26% greater adjusted odds of undergoing vitrectomy than White patients, while Black and Asian patients respectively had a 25% and 28% lower adjusted odds. Eyes undergoing vitrectomy on average had 3 times more intravitreal anti-VEGF injections in the preceding two years than eyes that did not undergo vitrectomy.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.