Abstract
Purpose :
To compare and analyze factors that influence surgical outcomes among African Americans (AA) and age matched Caucasian counterparts undergoing vitreoretinal surgery for diabetic retinopathy (DR) complications
Methods :
This retrospective study included patients that underwent vitreoretinal surgery for diabetic retinopathy complications with at least 6-months follow up after surgery. Data collected included best corrected visual acuity (BCVA) in log MAR, surgical complications, surgical success, duration of diabetes, history of prior proliferative DR and HbA1c. Wilcoxon-signed Rank test was used to analyze changes in visual acuity from baseline. We defined statistical significance as p ≤ 0.05
Results :
Thirty-two patients (52 eyes) with 6 months follow- up were included in the study. The median age was 62 years (IQR 48.5 to 65.5). There were 15 AA patients, and 17 Caucasian patients; 55% of the patient population were males. 66% of the patients have had diabetes for more than 10 years (Median duration 13 years; IQR 10 to 20 years). The average HbA1c was 7.76 for AA and 9.18 for Caucasians and average duration (years) of diabetes for AA was 13.67 compared to 16.8 Caucasians. For AA patients (24 eyes), the average log MAR VA at baseline 0.648 ± 0.612, 1-month post-op = 1.24±0.780 (Snellen’s equivalent 20/300), and 6 months post-op =1.12±0.895 (Snellen’s equivalent 20/250). For Caucasians, baseline log MAR VA was 1.089±0.82 (Snellen’s equivalent 20/200) 1-month post-op= 0.821±0.723 (Snellen’s equivalent 20/125), and 6 months post-op = 0.914±0.804, p=0.304). AA group showed an average worsening of VA from baseline of ~+0.60 (p=0.002) and +0.4 (p=0.147) while their Caucasian counterparts had improvement ~-0.6 (p= 0.103) and -0.4 (p= 0.304) at 1 and 6 months respectively. Additionally, we noticed 53% of AA lost more than three lines of vision and 20% gained more than 3 lines of vision. 45% of Caucasians gained more than 3 lines of acuity at 6 months and 32% lost more than three lines of acuity.
Conclusions :
Despite good surgical success in both groups, Caucasian patients gained more lines of visual acuity at 6 months compared to their age-matched African American counterparts. In addition to the various systemic and ocular factors, race is an independent risk factor for visual prognosis for surgical outcomes in eyes with diabetic retinopathy complcaitions
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.