Proliferative diabetic retinopathy (PDR) is one of the most common causes of vision loss in diabetic patients, and a new study stresses the importance of catching changes as early as possible. Researchers recently found that PDR is more severe in young patients than in senior patients, despite a shorter disease duration.
This retrospective study included 116 eyes of 92 patients who underwent vitrectomy for PDR and were followed for at least 24 months. The patients were grouped based on age, with younger patients averaging an age of 37.5 and senior patients averaging 57.6 years of age. Younger patients had an average disease duration of 9.17 ± 6.49 years at the time of operation, while senior patients averaged 13.98 ± 6.89 years.
The team reported that 62.1% of eyes in the young patient group had tractional retinal detachment secondary to PDR, while only 12.1% of eyes in the senior patient group had this surgery indication. Instead, senior eyes were more likely to present with vitreous hemorrhage as a surgical indication.
They noted that best-corrected visual acuity increased in 70.7% of young eyes and in 81.0% of senior eyes at the final follow-up. Another 15.5% of young eyes stabilized compared with 3.4% of senior eyes and 13.8% of young eyes experienced a decrease in visual acuity compared with 15.5% of senior eyes.
The investigators observed several postoperative complications, including recurrent vitreous hemorrhage (24.1%, 19.0%), retinal detachment (3.4%, 0.0%), neovascular glaucoma (27.6%, 1.7%) and nuclear sclerosis (53.4%, 3.4%) in young and senior patients, respectively.
“Vitrectomy is an effective method for treatment of severe PDR in young patients,” the study authors concluded in their final paper. “However, the outcomes are limited and worse than that in treating senior patients.”
Liao M, Wang X, Yu J, et al. Characteristics and outcomes of vitrectomy for proliferative diabetic retinopathy in young versus senior patients. BMC Ophthalmol. October 19, 2020. [Epub ahead of print].