Department of Ophthalmology, Tianjin Medical University General Hospital, No.154 Anshan Road, Tianjin, 300052, China.
Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China.
BMC Ophthalmol. 2020 Oct 19;20(1):416. doi: 10.1186/s12886-020-01688-3.
Proliferative diabetic retinopathy (PDR) is one of the most common cause of vision loss in diabetic patients, and the incidence age of PDR patients gradually gets younger. This study aims to compare the characteristics of PDR and outcomes following vitrectomy in young and senior patients.
This is a retrospective case series study. Data of 116 eyes of 92 patients who underwent vitrectomy for PDR from February 2012 to February 2017 were reviewed, which were divided into young and senior patient groups. All patients were followed up for 24 months at least.
There were 62.1% of eyes with tractional retinal detachment secondary to PDR in the young patient group, while only 12.1% of eyes in the senior patient group with this surgery indication. (P < 0.001) The best corrected visual acuity increased in 41 eyes (70.7%), stable in 9 eyes (15.5%), and decreased in 8 eyes (13.8%) in young patients at the final follow-up. And it increased in 47 eyes (81.0%), stable in 2 eyes (3.4%), and decreased in 9 eyes (15.5%) in senior patients.(P = 0.085) Postoperative complications mainly included recurrent vitreous hemorrhage (24.1%), retinal detachment (3.4%), neovascular glaucoma (NVG) (27.6%) and nuclear sclerosis (53.4%) in young patients, and it was 19.0, 0.0, 1.7 and 3.4% in senior patients respectively.
PDR of young patients is more severe than that of senior patients, and vitrectomy is an effective and safe method for PDR treatment. NVG is a main and severe complication besides nuclear sclerosis in young patients, and the incidence of NVG is higher compared to that in senior patients.
增生型糖尿病视网膜病变（PDR）是糖尿病患者视力丧失的最常见原因之一，且 PDR 患者的发病年龄逐渐年轻化。本研究旨在比较年轻和老年 PDR 患者行玻璃体切除术的特点和结局。
这是一项回顾性病例系列研究。对 2012 年 2 月至 2017 年 2 月期间因 PDR 接受玻璃体切除术的 92 例患者的 116 只眼进行了回顾性分析，将患者分为年轻患者组和老年患者组。所有患者的随访时间均至少为 24 个月。
年轻患者组因 PDR 导致牵拉性视网膜脱离的眼占 62.1%，而老年患者组中具有该手术适应证的眼仅占 12.1%（P＜0.001）。在最终随访时，年轻患者组中 41 只眼（70.7%）的最佳矫正视力提高，9 只眼（15.5%）稳定，8 只眼（13.8%）下降。老年患者组中 47 只眼（81.0%）的最佳矫正视力提高，2 只眼（3.4%）稳定，9 只眼（15.5%）下降（P=0.085）。年轻患者术后主要并发症包括复发性玻璃体积血（24.1%）、视网膜脱离（3.4%）、新生血管性青光眼（NVG）（27.6%）和核性白内障（53.4%），老年患者的发生率分别为 19.0%、0.0%、1.7%和 3.4%。
年轻患者的 PDR 比老年患者更严重，玻璃体切除术是治疗 PDR 的有效且安全的方法。NVG 是年轻患者除核性白内障外的主要且严重的并发症，其发生率高于老年患者。
