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1型或2型糖尿病青年患者增生性糖尿病视网膜病变25G玻璃体切除术的临床特征、人口统计学和手术结果比较

Comparison of Clinical Profiles, Demographics, and Surgical Outcomes of 25-Gauge Vitrectomy for Proliferative Diabetic Retinopathy in Young Adults with Type 1 or Type 2 Diabetes.

作者信息

Zhang Meng, Zhang Juan, Xu Gezhi, Ruan Lu, Huang Xin

机构信息

Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, People's Republic of China.

Institute of Eye Research, Eye & ENT Hospital, Fudan University, Shanghai, 200031, People's Republic of China.

出版信息

Diabetes Metab Syndr Obes. 2023 Jun 29;16:1967-1975. doi: 10.2147/DMSO.S412157. eCollection 2023.

Abstract

PURPOSE

Proliferative diabetic retinopathy (PDR) is a leading cause of poor vision in young adults. This study sought to evaluate the clinical characteristics and outcomes of primary vitrectomy for PDR in young adults.

PATIENTS AND METHODS

Medical data were retrospectively collected at a large ophthalmology hospital in China. We analyzed data for 99 patients (140 eyes) aged <45 years with T1D or T2D who underwent primary vitrectomy for PDR-related complications.

RESULTS

There were 18 patients with T1D and 81 patients with T2D. The proportion of males was significantly greater than that of females in both groups. The T1D group had a longer duration of diabetes ( = 0.008), younger age at primary vitrectomy ( = 0.049), and lower body mass index ( < 0.001) than the T2D group. The proportion of eyes with rhegmatogenous retinal detachment (RRD) was greater but the proportion of eyes with traction retinal detachment (TRD) was lower in the T1D group than in the T2D group. The final best-corrected visual acuity (BCVA) improved or remained stable in 100% and 85.3% of eyes and decreased in 0% and 14.7% of eyes in the T1D and T2D groups, respectively. After surgery, the incidence of postoperative complications was significant greater in the T2D group than in the T1D group ( = 0.045). Factors influencing the final visual acuity included preoperative BCVA in both groups, the duration of diabetes ( = 0.031) and preoperative FVP ( = 0.004) in the T1D group, and preoperative RRD ( < 0.001) and postoperative NVG ( < 0.001) in the T2D group.

CONCLUSION

In this retrospective study, young adults with T2D who underwent vitrectomy had worse final visual acuity and more complications than young adults with T1D.

摘要

目的

增殖性糖尿病视网膜病变(PDR)是年轻成年人视力低下的主要原因。本研究旨在评估年轻成年人PDR行玻璃体切除术的临床特征及预后。

患者与方法

在中国一家大型眼科医院回顾性收集医疗数据。我们分析了99例年龄<45岁的1型糖尿病(T1D)或2型糖尿病(T2D)患者(140只眼)因PDR相关并发症行玻璃体切除术的数据。

结果

1型糖尿病患者18例,2型糖尿病患者81例。两组男性比例均显著高于女性。与2型糖尿病组相比,1型糖尿病组糖尿病病程更长(P = 0.008),初次玻璃体切除术时年龄更小(P = 0.049),体重指数更低(P < 0.001)。1型糖尿病组孔源性视网膜脱离(RRD)眼的比例高于2型糖尿病组,但牵拉性视网膜脱离(TRD)眼的比例低于2型糖尿病组。1型糖尿病组和2型糖尿病组分别有100%和85.3%的眼最终最佳矫正视力(BCVA)提高或保持稳定,0%和14.7%的眼视力下降。术后,2型糖尿病组术后并发症发生率显著高于1型糖尿病组(P = 0.045)。影响最终视力的因素包括两组的术前BCVA、1型糖尿病组的糖尿病病程(P = 0.031)和术前纤维血管性增殖(P = 0.004),以及2型糖尿病组的术前RRD(P < 0.001)和术后新生血管性青光眼(P < 0.001)。

结论

在这项回顾性研究中,行玻璃体切除术的2型糖尿病年轻成年人比1型糖尿病年轻成年人最终视力更差,并发症更多。

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