Analysis of Risk Factors for Revitrectomy in Eyes with Diabetic Vitreous Hemorrhage

Haoxin Guo,1,* Wenbo Li,1,* Kuan Wang,1,2 Zetong Nie,1 Xiang Zhang,1 Siqiong Bai,1 Naxin Duan,1 Xiaorong Li,1 Bojie Hu1 1Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optom...

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Main Authors: Guo H, Li W, Wang K, Nie Z, Zhang X, Bai S, Duan N, Li X, Hu B
Format: Article
Language:English
Published: Dove Medical Press 2023-09-01
Series:Diabetes, Metabolic Syndrome and Obesity
Subjects:
Online Access:https://www.dovepress.com/analysis-of-risk-factors-for-revitrectomy-in-eyes-with-diabetic-vitreo-peer-reviewed-fulltext-article-DMSO
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author Guo H
Li W
Wang K
Nie Z
Zhang X
Bai S
Duan N
Li X
Hu B
author_facet Guo H
Li W
Wang K
Nie Z
Zhang X
Bai S
Duan N
Li X
Hu B
author_sort Guo H
collection DOAJ
description Haoxin Guo,1,&ast; Wenbo Li,1,&ast; Kuan Wang,1,2 Zetong Nie,1 Xiang Zhang,1 Siqiong Bai,1 Naxin Duan,1 Xiaorong Li,1 Bojie Hu1 1Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin University Eye Hospital, Tianjin, People’s Republic of China; 2Cangzhou Eye Hospital, Cangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Bojie Hu, Email bhu07@tmu.edu.cnPurpose: We aimed to investigate the risk factors associated with revitrectomy in eyes with diabetic vitreous hemorrhage and to determine the prognosis of these patients at least one year postoperatively.Patients and Methods: This retrospective case-control study had a minimum follow-up period of one year. Patients were divided into single vitrectomy group (control group, n=202) and revitrectomy group (case group, n=36) for analysis. The indications, number, and timing of revitrectomies were documented. And the revitrectomy group was further divided into two vitrectomies group (n=30) and three or more vitrectomies group (n=6). The best-corrected visual acuity (BCVA) at the last follow-up and the occurrence of neovascular glaucoma (NVG) were compared among the single vitrectomy, two vitrectomies and three or more vitrectomies groups. We conducted a thorough collection of patient data and used univariate and binary logistic regression analyses to identify the risk factors associated with revitrectomy.Results: A total of 197 patients (238 eyes) were included. Thirty-six eyes (15.1%) required revitrectomy with six eyes (2.5%) undergoing three or more vitrectomies during the follow-up period. The median duration of the second vitrectomy was 3 (2– 6) months. The indications for a second vitrectomy included 28 eyes (77.8%) of postoperative vitreous hemorrhage and 7 eyes (22.2%) combined with tractional retinal detachment. Patients undergoing three or more vitrectomies had significantly worse postoperative BCVA and a higher incidence of NVG (P< 0.01). Fibrinogen> 4 g/L (P< 0.001) and preoperative anti-vascular endothelial growth factor intravitreal injection (P=0.015) were independent risk factors for revitrectomy, and glycated hemoglobin A1c (HbA1c)> 10% (P=0.049) showed significant difference only in univariate analysis.Conclusion: Patients requiring revitrectomy tended to have higher fibrinogen levels, tightly adhered fibrovascular membranes, higher HbA1c levels, and worse prognoses.Keywords: proliferative diabetic retinopathy, vitreous hemorrhage, revitrectomy, fibrinogen, retinal ischemia
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spelling doaj.art-e18a2bf20fc2472b88a46ec6db92a7ba2023-09-21T19:08:59ZengDove Medical PressDiabetes, Metabolic Syndrome and Obesity1178-70072023-09-01Volume 162865287486794Analysis of Risk Factors for Revitrectomy in Eyes with Diabetic Vitreous HemorrhageGuo HLi WWang KNie ZZhang XBai SDuan NLi XHu BHaoxin Guo,1,&ast; Wenbo Li,1,&ast; Kuan Wang,1,2 Zetong Nie,1 Xiang Zhang,1 Siqiong Bai,1 Naxin Duan,1 Xiaorong Li,1 Bojie Hu1 1Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin University Eye Hospital, Tianjin, People’s Republic of China; 2Cangzhou Eye Hospital, Cangzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Bojie Hu, Email bhu07@tmu.edu.cnPurpose: We aimed to investigate the risk factors associated with revitrectomy in eyes with diabetic vitreous hemorrhage and to determine the prognosis of these patients at least one year postoperatively.Patients and Methods: This retrospective case-control study had a minimum follow-up period of one year. Patients were divided into single vitrectomy group (control group, n=202) and revitrectomy group (case group, n=36) for analysis. The indications, number, and timing of revitrectomies were documented. And the revitrectomy group was further divided into two vitrectomies group (n=30) and three or more vitrectomies group (n=6). The best-corrected visual acuity (BCVA) at the last follow-up and the occurrence of neovascular glaucoma (NVG) were compared among the single vitrectomy, two vitrectomies and three or more vitrectomies groups. We conducted a thorough collection of patient data and used univariate and binary logistic regression analyses to identify the risk factors associated with revitrectomy.Results: A total of 197 patients (238 eyes) were included. Thirty-six eyes (15.1%) required revitrectomy with six eyes (2.5%) undergoing three or more vitrectomies during the follow-up period. The median duration of the second vitrectomy was 3 (2– 6) months. The indications for a second vitrectomy included 28 eyes (77.8%) of postoperative vitreous hemorrhage and 7 eyes (22.2%) combined with tractional retinal detachment. Patients undergoing three or more vitrectomies had significantly worse postoperative BCVA and a higher incidence of NVG (P< 0.01). Fibrinogen> 4 g/L (P< 0.001) and preoperative anti-vascular endothelial growth factor intravitreal injection (P=0.015) were independent risk factors for revitrectomy, and glycated hemoglobin A1c (HbA1c)> 10% (P=0.049) showed significant difference only in univariate analysis.Conclusion: Patients requiring revitrectomy tended to have higher fibrinogen levels, tightly adhered fibrovascular membranes, higher HbA1c levels, and worse prognoses.Keywords: proliferative diabetic retinopathy, vitreous hemorrhage, revitrectomy, fibrinogen, retinal ischemiahttps://www.dovepress.com/analysis-of-risk-factors-for-revitrectomy-in-eyes-with-diabetic-vitreo-peer-reviewed-fulltext-article-DMSOproliferative diabetic retinopathyvitreous hemorrhagerevitrectomyfibrinogenretinal ischemia
spellingShingle Guo H
Li W
Wang K
Nie Z
Zhang X
Bai S
Duan N
Li X
Hu B
Analysis of Risk Factors for Revitrectomy in Eyes with Diabetic Vitreous Hemorrhage
Diabetes, Metabolic Syndrome and Obesity
proliferative diabetic retinopathy
vitreous hemorrhage
revitrectomy
fibrinogen
retinal ischemia
title Analysis of Risk Factors for Revitrectomy in Eyes with Diabetic Vitreous Hemorrhage
title_full Analysis of Risk Factors for Revitrectomy in Eyes with Diabetic Vitreous Hemorrhage
title_fullStr Analysis of Risk Factors for Revitrectomy in Eyes with Diabetic Vitreous Hemorrhage
title_full_unstemmed Analysis of Risk Factors for Revitrectomy in Eyes with Diabetic Vitreous Hemorrhage
title_short Analysis of Risk Factors for Revitrectomy in Eyes with Diabetic Vitreous Hemorrhage
title_sort analysis of risk factors for revitrectomy in eyes with diabetic vitreous hemorrhage
topic proliferative diabetic retinopathy
vitreous hemorrhage
revitrectomy
fibrinogen
retinal ischemia
url https://www.dovepress.com/analysis-of-risk-factors-for-revitrectomy-in-eyes-with-diabetic-vitreo-peer-reviewed-fulltext-article-DMSO
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