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增生型糖尿病视网膜病变行玻璃体切除术患者的视力预后预测因素。

Predictors of visual outcome after pars plana vitrectomy secondary to proliferative diabetic retinopathy.

机构信息

Ophthalmology Clinic, University Clinical Center Sarajevo, Sarajevo, Bosnia and Herzegovina.

Ophthalmology Department, "Prim. Dr. Abdulah Nakas" General Hospital, Sarajevo, Bosnia and Herzegovina.

出版信息

Rom J Ophthalmol. 2023 Jul-Sep;67(3):283-288. doi: 10.22336/rjo.2023.46.

Abstract

Advanced proliferative diabetic retinopathy can lead to serious ophthalmological complications, including blindness. This research aimed to determine visual outcomes after pars plana vitrectomy secondary to proliferative diabetic retinopathy, as well as to identify its predictors. This prospective clinical study was performed in the Ophthalmology Clinic of the Clinical Centre University of Sarajevo. 60 subjects (eyes) with performed pars plana vitrectomy secondary to proliferative diabetic retinopathy were included in the study. After univariate linear regression analysis, glucose, HbA1c, vascular endothelial growth factor, previous pan-retinal laser photocoagulation, baseline best corrected visual acuity, gas injection, vitreous haemorrhage, iris rubeosis, and glaucoma were found to be statistically significant parameters associated with postoperative visual outcome (p<0.05). Multivariate linear regression analysis was performed to evaluate the association between factors and postoperative best corrected visual acuity. Only intravitreal vascular endothelial growth factor concentration, previous pan-retinal photocoagulation, and gas injection remained statistically significant associated with postoperative best corrected visual acuity (p<0.05). Vitrectomy is an effective treatment for advanced proliferative diabetic retinopathy. Factors correlated with the better visual outcome are good systemic control, previous pan-retinal photocoagulation, low intravitreal vascular endothelial growth factor concentration, younger age, intraoperative internal gas tamponade, combined phacoemulsification and pars plana vitrectomy surgery, and the absence of postoperative complications. : PDR = proliferative diabetic retinopathy, VEGF = vascular endothelial growth factor, TDR = tractional retinal detachment, BCVA = best corrected visual acuity, DR = diabetic retinopathy, RDD = rhegmatogenous retinal detachment, NVG = neovascular glaucoma, BRVO = branch retinal vein occlusion, CBC = complete blood count, DBT = differential blood count, ESR = erythrocyte sedimentation rate, HbA1c = glycosylated hemoglobin, PHACO = phacoemulsification, ILM = internal limiting membrane, PPV = pars plana vitrectomy, IOP = intraocular pressure, PRP = pan-retinal photocoagulation, ETDRS = Early treatment diabetic retinopathy study.

摘要

增生性糖尿病视网膜病变可导致严重的眼部并发症,包括失明。本研究旨在确定增生性糖尿病性视网膜病变继发行玻璃体切割术后的视力结果,并确定其预测因素。这项前瞻性临床研究在萨拉热窝临床中心眼科诊所进行。60 例(眼)因增生性糖尿病性视网膜病变行玻璃体切割术的患者纳入本研究。在单因素线性回归分析后,发现血糖、糖化血红蛋白、血管内皮生长因子、既往全视网膜激光光凝、基线最佳矫正视力、气体注入、玻璃体积血、虹膜红变和青光眼是与术后视力结果相关的统计学显著参数(p<0.05)。进行多因素线性回归分析以评估因素与术后最佳矫正视力之间的关系。只有眼内血管内皮生长因子浓度、既往全视网膜光凝和气体注入仍然与术后最佳矫正视力有统计学显著相关(p<0.05)。玻璃体切割术是治疗晚期增生性糖尿病性视网膜病变的有效方法。与更好的视力结果相关的因素是良好的全身控制、既往全视网膜光凝、低眼内血管内皮生长因子浓度、较年轻的年龄、术中内眼气体填充、联合超声乳化白内障吸除术和玻璃体切割术以及术后无并发症。:PDR = 增生性糖尿病性视网膜病变,VEGF = 血管内皮生长因子,TDR = 牵引性视网膜脱离,BCVA = 最佳矫正视力,DR = 糖尿病性视网膜病变,RDD = 孔源性视网膜脱离,NVG = 新生血管性青光眼,BRVO = 分支视网膜静脉阻塞,CBC = 全血细胞计数,DBT = 差异血细胞计数,ESR = 红细胞沉降率,HbA1c = 糖化血红蛋白,PHACO = 超声乳化白内障吸除术,ILM = 内界膜,PPV = 玻璃体切割术,IOP = 眼内压,PRP = 全视网膜光凝,ETDRS = 糖尿病性视网膜病变早期治疗研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8fd/10591430/61c27bfceddb/RomJOphthalmol-67-283-g001.jpg

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