Role of the vitreous in diabetic retinopathy. II. Active and inactive vitreous changes.

The course of the vitreoretinal relationship in 272 eyes with diabetic retinopathy was studied retrospectively in an attempt to identify the prognostic role of the vitreous. In eyes with initial nonproliferative diabetic retinopathy, the development of neovascularization had a positive correlation with eventual partial posterior vitreous detachment (PVD) and a negative correlation with complete PVD. In eyes with initial proliferative diabetic retinopathy, those with active vitreous changes had a poor prognosis and those with inactive vitreous changes, an apparently good prognosis. Photocoagulation for retinal neovascularization was successful in most eyes with stable no-PVD but less successful in eyes that progressed to partial PVD. Therefore, considering the diabetic vitreous changes from a prognostic standpoint, the data suggest that if early proliferative changes are observed, photocoagulation before partial PVD develops might be considered.