增殖性糖尿病视网膜病变玻璃体切除术的长期预后：一项在中国的真实世界研究。

Long-term outcomes of vitrectomy for proliferative diabetic retinopathy: a real world study in China.

作者信息

Mei Jinghao, Zhou Hantao, Deng Chuying, Wang Shimeng, Guo Binghua, Lin Wei, Lin Zushun, Lin Ke, Wu Ronghan, Lin Zhong

机构信息

National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, 325027, China.

Department of Opthalmology, Lishui Municipal Central Hospital, Lishui, China.

出版信息

Int Ophthalmol. 2025 Aug 30;45(1):366. doi: 10.1007/s10792-025-03722-z.

DOI:10.1007/s10792-025-03722-z

PMID:40884584

Abstract

PURPOSE

To investigate long-term outcomes and their predictive factors in Chinese patients with proliferative diabetic retinopathy (PDR) after vitrectomy.

STUDY DESIGN

Retrospective and observational.

METHODS

PDR patients who underwent vitrectomy in a tertiary eye hospital from 2010 to 2020 were enrolled. The cumulative incidences of re-vitrectomy in the primary eye, vitrectomy in the contralateral eye, low vision (< 0.3 Snellen), and postoperative complications were calculated.

RESULTS

A total of 1094 patients were included in the analysis. The 1-, 3-, and 5-year cumulative incidences for low vision in both eyes were 18.9%, 34.7%, and 44.4%, respectively. The 1-, 5-, and 10-year cumulative incidences for re-vitrectomy in the primary eye were 7.4%, 9.9%, and 9.9%, respectively, and for vitrectomy in the contralateral eye were 31.0%, 62.7%, and 79.5%, respectively. Vitrectomy in the contralateral eye was associated with younger age (hazard ratio [HR] = 0.99, 95% confidence interval [CI] 0.98-0.99), higher glycated hemoglobin (HR = 1.17, 95% CI 1.08-1.27), no preoperative photocoagulation (HR = 0.55, 95% CI 0.39-0.78), severer diabetic retinopathy level (HR = 2.28, 95% CI 1.56-3.33), and poorer preoperative vision (HR = 1.35, 95% CI 1.14-1.61). The cumulative postoperative incidences of the primary eye at 1, 5, and 10 years were 5.7%, 9.9%, and 9.9% for vitreous hemorrhage, 4.2%, 5.1%, and 5.1% for retinal detachment, and 2.8%, 6.2%, and 8.1% for neovascular glaucoma, respectively.

CONCLUSION

This study reported a comprehensive post-vitrectomy incidence and predictive factors in Chinese PDR patients in a long-term follow up. This would aid in the clinical understanding of this lifelong disease.

摘要

目的

研究中国增殖性糖尿病视网膜病变（PDR）患者玻璃体切除术后的长期预后及其预测因素。

研究设计

回顾性观察研究。

方法

纳入2010年至2020年在一家三级眼科医院接受玻璃体切除术的PDR患者。计算术眼再次玻璃体切除术、对侧眼玻璃体切除术、低视力（<0.3 Snellen）及术后并发症的累积发生率。

结果

共1094例患者纳入分析。双眼低视力的1年、3年和5年累积发生率分别为18.9%、34.7%和44.4%。术眼再次玻璃体切除术的1年、5年和10年累积发生率分别为7.4%、9.9%和9.9%，对侧眼玻璃体切除术的累积发生率分别为31.0%、62.7%和79.5%。对侧眼玻璃体切除术与年龄较小（风险比[HR]=0.99，95%置信区间[CI] 0.98-0.99）、糖化血红蛋白水平较高（HR=1.17，95%CI 1.08-1.27）、术前未行光凝治疗（HR=0.55，95%CI 0.39-0.78）、糖尿病视网膜病变程度较重（HR=2.28，95%CI 1.56-3.33）及术前视力较差（HR=1.35，95%CI 1.14-1.61）相关。术眼玻璃体出血的术后1年、5年和10年累积发生率分别为5.7%、9.9%和9.9%，视网膜脱离的累积发生率分别为4.2%、5.1%和5.1%，新生血管性青光眼的累积发生率分别为2.8%、6.2%和8.1%。