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SYSTEMIC RISK FACTORS IN BILATERAL PROLIFERATIVE DIABETIC RETINOPATHY REQUIRING VITRECTOMY

Song, Young-Seok MD; Nagaoka, Taiji MD, PhD; Omae, Tsuneaki MD, PhD; Yokota, Harumasa MD, PhD; Takahashi, Atsushi MD, PhD; Yoshida, Akitoshi MD, PhD

doi: 10.1097/IAE.0000000000000886
Original Study

Purpose: The visual outcome after vitrectomy for proliferative diabetic retinopathy (PDR) is often poor. Bilateral vitrectomy has been especially associated with a poor visual prognosis in patients with PDR. The authors investigated the systemic risk factors for PDR requiring bilateral vitrectomy compared with unilateral vitrectomy.

Methods: The authors retrospectively reviewed 86 consecutive patients with Type 2 diabetes mellitus with PDR who underwent vitrectomy. These patients were divided into 2 groups: bilateral vitrectomy within 1 year (n = 25) and unilateral vitrectomy (n = 61). The authors compared the systemic risk factors: age, sex, duration of diabetes, hemoglobin A1c, body mass index, estimated glomerular filtration rate, uric albumin, hypertension, dyslipidemia, history of ischemic heart disease, arteriosclerosis obliterans, and smoking.

Results: There were significantly more cases with severe renal dysfunction in the bilateral vitrectomy group compared with the unilateral one (estimated glomerular filtration rate <30 mL/minute/1.73 m2; bilateral cases = 5/25; unilateral cases = 2/61; P = 0.02).

Conclusion: The authors found that severe renal dysfunction may be a risk factor in PDR requiring bilateral vitrectomy, indicating that careful attention needs to be paid to prevent the progression of diabetic retinopathy to severe PDR in the other eye if patients have severe unilateral PDR and severe renal dysfunction.

Current results reveal that severe renal dysfunction may be a risk factor of proliferative diabetic retinopathy requiring bilateral vitrectomy, indicating that careful attention needs to be paid to prevent the progression of DR to severe proliferative diabetic retinopathy in the other eye if patients have severe unilateral proliferative diabetic retinopathy and severe renal dysfunction.

Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Japan.

Reprint requests: Taiji Nagaoka, MD, PhD, Department of Ophthalmology, Asahikawa Medical University, Midorigaoka Higashi 2-1-1-1, Asahikawa, 078-8510, Japan; e-mail: nagaoka@asahikawa-med.ac.jp

Supported by a Grant-in-Aid for Scientific Research (B) 26861430 from the Ministry of Education, Science, and Culture, Tokyo. Japan (to Y.-S.S.).

None of the authors have any conflicting interests to disclose.

© 2016 by Ophthalmic Communications Society, Inc.