Long-term visual and retinopathy outcomes in a predominately type 2 diabetic patient population undergoing early vitrectomy and endolaser for severe vitreous haemorrhage.
Ratnarajan G., Mellington F., Saldanha M., de Silva SR., Benjamin L.
PURPOSE: To evaluate the long-term visual outcome of type 2 diabetic patients receiving early vitrectomy and endolaser for severe vitreous haemorrhage (VH). MATERIALS AND METHODS: Retrospective case note review of 88 eyes (69 type 2 diabetics and 19 type 1 diabetics) of 80 patients who underwent vitrectomy and endolaser within 6 months of VH. Post-operative and most recent VA, in addition to long-term retinopathy grading, were analysed. A subset of patients fulfilling the criteria for the Diabetic Retinopathy Vitrectomy Study was compared with this study. RESULTS: Mean pre-operative visual acuity (VA) in the type 2 group was 0.64 logMAR, with 1 eye showing perception light (PL), 10 eyes detecting hand movements (HMs), and 7 eyes counting fingers (CFs). At the 2-week post-operative visit, the mean VA had improved to 0.46 logMAR, with two eyes showing PL, two eyes detecting HM, and one eye CF (P=0.0002); at the last review, mean VA score was 0.36 logMAR, with three eyes showing PL and four eyes detecting HM (P=0.0008). Mean pre-operative VA in the type 1 group was 0.47 logMAR, with one eye showing PL, one eye detecting HM, and two eyes CF. At the 2-week post-operative visit, the mean VA had improved to 0.37 logMAR, with one eye showing PL (P=0.002), and at the latest review, the mean VA was 0.20 logMAR (P=0.027). CONCLUSION: Our study shows that type 2 DM patients can observe improvement in VA and stabilisation of their proliferative retinopathy after early vitrectomy and endolaser for vitreous haemorrahage, which is maintained after long-term follow-up.